Gov. John Bel Edwards, a Democrat, has decided to go around the Louisiana Legislature to get $15.4 billion worth of Medicaid contracts approved, after House Republican leadership declined to endorse the arrangements three times over the past month.
The governor is planning to use a state rule to move forward with the five contracts on an emergency basis for 23 months, without legislative approval. By doing so, he won’t have to give into the House GOP leadership demands for more oversight of Medicaid spending.
Under state law, the Edwards administration said it is allowed to pass “emergency contracts” if an imminent threat to public health exists. The contracts are collectively worth a quarter of the state’s budget.
The arrangements look almost exactly like the contracts he has put before the Legislature’s budget committees three times over the past month — with no success. Lawmakers declined to consider the contracts when they were first presented, and then the House members on the Appropriations Committee voted them down twice in subsequent meetings, including one held Friday (Nov. 17).
“I thought I made it very clear that we needed a decision on Friday,” said Matthew Block, general counsel for the governor, in an interview Tuesday.
House Appropriations Committee Chairman Cameron Henry, R-Metairie, said he was disappointed that the Edwards administration had decided to circumvent the traditional legislative process. Henry said it was appropriate to have more than one hearing on these contracts, given their size.
“I think asking questions is not obstructionist. I think it is doing our jobs,” Henry said Tuesday afternoon.
Henry said he hadn’t had a chance to talk to his staff yet and couldn’t comment on whether the governor had the authority to pursue “emergency contracts” in lieu of getting approval from the Legislature’s budget committees. Still, he said he was uncomfortable with setting a precedent that “once the Legislature decides to ask too many questions, [Edwards] can go ahead and cut us out of the process.”
The Edwards administration said it worried the House Appropriations Committee would never approve the contracts, which oversee health care coverage for 1.2 million Medicaid recipients in the state, including 700,000 children. The current contracts they would replace expire Jan. 31.
If they never got approved, the Edwards administration has said it would cause chaos for Louisiana’s health care industry and that the state Medicaid program would not be funded from April to June.
Henry, the Republican leading the fight against the governor on the contracts, has always said House leadership intended to pass the contracts, likely during a vote in December. But he was insisting the governor add certain oversight provisions to the agreements before they were approved.
The Edwards administration said the governor wasn’t assured that the contracts would get a favorable vote in December, even if they added some oversight language Henry wanted. The consequences of not having the agreements renewed were too dramatic to risk a rejection again, according to the governor’s staff.
“The chairman has given no indication that they will pass in December,” said Richard Carbo, the governor’s spokesman, referring to Henry.
As somewhat of a concession to Henry, the Edwards administration has inserted language into its new “emergency contracts” meant to clarify that the Louisiana Legislative Auditor currently has the authority to explore and provide oversight over Medicaid spending. The language won’t necessarily alleviate Henry’s concerns though. Henry has been asking for much more explicit language giving the legislative auditor authority in the agreements, which Edwards has declined to include.
On Friday, the auditor, Daryl Purpera, told lawmakers the Medicaid contracts put forward by the governor allowed him to do his job, though he also added that having language inserted that explicitly requires the legislative auditor’s oversight — as Henry has requested — would be helpful.
Purpera, who seemed uncomfortable being forced to side with either the governor or the House Republicans, works directly for the Legislature, which the GOP controls.
The Edwards administration said it wouldn’t have enough time to implement the arrangements if he waited until December to see if the House passed them. If he started moving forward with “emergency contracts” then, they might not be in place in time for the Jan. 31 deadline, according to Block.
“We simply would not have a viable backup plan in place if we started in December,” he said.
Senate President John Alario, R-Westwego, agreed with Edwards’ decision to go forward with “emergency contracts”. Unlike the House Appropriations Committee, the Senate Finance Committee, including Alario, unanimously voted in favor of the Medicaid arrangements put forward by the governor this month. The Senate president said he, too, was getting nervous the contracts would never get approved by the House.
“The decision has to be made so there is some stability,” Alario said in an interview. “It’s too serious of a concern to wait” until December.
The Edwards administration started working on the “emergency contracts” plan a couple of weeks ago, according to Block. The governor’s staff discussed the maneuver with Alario prior to making a public announcement about it, but the governor’s staff had not talked personally about the “emergency contracts” with Henry as of Tuesday morning. Instead, Block sent Henry a letter Monday evening outlining the governor’s intentions to work around the lawmakers.
As a parting shot to the governor, Henry said he didn’t think Edwards would have tolerated this type of maneuver when he was a member of the House. “If Gov. Edwards was a state representative and Bobby Jindal pulled this move? Rep. Edwards would have been screaming from the top of the Capitol,” Henry said. “And he wouldn’t have been screaming nice things.”
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Julia O’Donoghue is a state politics reporter based in Baton Rouge. She can be reached at jodonoghue@nola.com or on Twitter at @jsodonoghue. Please consider following us on Facebook at NOLA.com and NOLA.com-Baton Rouge.