Louisiana—with its parishes, its Continental system of laws and its Cajun-inflected way of life—has always been unique among American states. But as Governing points out in a new article, there’s another distinction that makes Louisiana different: It’s the only state that has for centuries maintained a network of public teaching hospitals to treat the poor and uninsured.
Now that system could be in trouble, the publication reports, thanks to recent state decisions and federal changes to the way safety-net hospitals are funded. As a result, Louisiana officials must figure out if they can maintain their safety net and still refuse federal Medicaid money. It’s a challenge the 22 other states that haven’t expanded Medicaid will likely encounter in the coming years.
Faced with a major budget gap in 2012, Gov. Bobby Jindal moved to privatize nearly all 10 of the state-run hospitals, which receive most of their funding from the federal government through the Disportionate Share Hospital program. Today, more than a year into the experiment, Governing reports the plan has certainly seen some clear successes. Patient wait times, for instance, have dropped dramatically. But the change has led to some unanticipated consequences as well. Privatization resulted in the closure of two hospitals, and instead of heading to any of the other now public-private facilities for care, uninsured patients started visiting private “nonpartner” facilities that don’t receive any DSH compensation.
“The problem is that Louisiana’s pool of DSH funding goes almost exclusively to the now public-private hospitals,” Governing reports. “That’s causing short-term headaches as more nonpartner private hospitals take on indigent patients who previously went to now-shuttered public facilities.”
The publication highlights the case of Baton Rouge General, which in August announced the closure of the emergency room at its Mid City campus, but was spared that cut when the state offered up $18 million in short-term aid to keep the facility open. Read the full story.
