State senators Monday shelved the latest effort to give Louisiana’s legislative auditor access to income tax data to check Medicaid eligibility, in an ongoing fight that has developed since Gov. John Bel Edwards expanded the state’s Medicaid program to cover thousands more people.
The Senate Revenue and Fiscal Affairs Committee voted 5-3 against the House-approved proposal from Republican Rep. Tony Bacala, of Prairieville, the second year in a row the committee has rejected such an idea. The vote fell along party lines with Republicans supporting Bacala’s House Bill 72 and Democrats opposed.
Bacala, supported by Legislative Auditor Daryl Purpera, said he’s seeking the information to combat fraud and save taxpayers money.
“Why are we afraid of oversight?” Bacala said. “Truly, what’s in my heart is to ensure we spend the tax dollars properly.”
Opponents said the health department has improved its wage-verification system to check eligibility and they said they worried confidential tax data would get leaked to the public. Democrats also said Bacala’s approach seems to target the poor.
“The people that are in this (Medicaid expansion) program are working people trying to get somewhere,” said Sen. Gerald Boudreaux, a Lafayette Democrat. “I’m going to stay with the department and ask them to continue with their internal controls.”
Purpera said his office has access to wage data, to compare against eligibility, but he said that doesn’t include self-employment income and other types of income.
“We’re only looking at half the data,” he said.
Sen. Troy Carter, a New Orleans Democrat, suggested speculation about hundreds of millions of dollars in misspent Medicaid money is overblown. He said the larger waste and fraud likely rests with health care providers and companies that are managing the care of Medicaid patients, rather than with Medicaid enrollees.
“Why aren’t we investigating provider fraud?” Carter said. “It’s sexier to go after poor people than it is to go after corporations.”
Bacala said he doesn’t know where waste or fraud is greater. He said the attorney general’s office, which investigates provider fraud, hasn’t asked for any additional authority to do its work, while Purpera has indicated he needs broader access to records to do his reviews.
Purpera’s office has released audits documenting money spent on ineligible services and suggesting millions could have been spent on people who earned too much to receive the government-financed health insurance.
The auditor’s office has intensified its reviews after Edwards, a Democrat, expanded the Medicaid program in 2016, as allowed under the federal health care law. About 500,000 new people were added to the Medicaid rolls — and the health department’s budget grew to be nearly half the state’s operating budget.
Bacala has proposed the tax data idea multiple times, only to fail to win passage. He broadened the legislation this session beyond Medicaid to give the auditor access to tax return data to crosscheck eligibility for state-administered programs that use an “income or asset test.” That could also sweep in the food stamp program, among others.