John Bel Edwards fends off charges of creating health care chaos in Louisiana

With hundreds of thousands of Louisianians facing health insurance limbo, Democratic Gov. John Bel Edwards is fending off charges he created the chaos with raw political retribution.

Mr. Edwards, who is seeking reelection this year, has touted his expansion of Medicaid through Obamacare as one of his signature accomplishments, with his campaign advertising featuring random Louisianians saying they wouldn’t have coverage otherwise.

But that expansion has been dogged by controversy and costs, and now Republican Rep. Ralph Abraham, who is challenging Mr. Edwards, has bluntly accused the governor of jeopardizing health care coverage as political payback.

Standing on the steps of Louisiana’s Department of Health in Baton Rouge last week, Mr. Abraham delivered a scathing indictment of Mr. Edwards’ stewardship of the department.

The LDH “is one of the most ineffective and poorly run government agencies in Louisiana — and that’s saying something,” Mr. Abraham said.

At issue is approximately $8 billion in contracts along with roughly half of the Louisiana budget.

Louisiana’s Medicaid expansion involves multiple contracts with managed care organizations (MCOs), the biggest of which is with Louisiana Healthcare Connections (LHCC) that covers roughly 30% of enrollees, or more than 450,000 individuals.

LHCC’s parent company, Centene Management, has emerged as the third largest contributor to the Republican Governors Association, giving it $1 million to date, according to the Center for Responsive Politics.

Less than two days after The Advocate reported that contribution, the Edwards administration rejected LHCC’s latest bid, a rejection that is now tied up with formal protests and potential lawsuits and has forced Louisiana to patch up coverage in some cases through emergency contracts.

Mr. Abraham says it is easy to connect the dots, but the notion Mr. Edwards cut out LHCC as “political retribution,” because of Centene’s donations is completely false, his campaign said.

“Putting aside all the other reasons it’s a dumb accusation, it doesn’t even hold up under the Abraham’s folks’ own flawed logic,” said Eric Holl, a campaign spokesman. “Centene has given more than $2 million to the [Democratic Governors’ Association] since Gov. Edwards took office.”

Yet complaints about the process have not been confined to Republicans and losing bidders.

Democratic Rep. Cedric Richmond of New Orleans, and former New Orleans Mayor Marc Morial, who now heads the National Urban League, have also written Mr. Edwards questioning his decisions.

Not only is the current situation frightening tens of thousands of constituents, but the new contract could result in the loss of more than 700 jobs in Louisiana, Mr. Richmond and Mr. Morial noted.

Even before the latest blooming scandal, Louisiana’s Medicaid expansion has been bedeviled by controversy.

First, it emerged that hundreds of people with six-figure incomes and thousands of people overall who should have never been eligible for the subsidies were enrolled. Then, in the course of sorting out those individuals, some who were entitled to Medicaid found themselves temporarily cut off.

In addition, the administration has acknowledged it underestimated the cost to Louisiana of the expansion by roughly $400 million.

Now, the situation is completely opaque, with both LHCC and Aetna, another losing bidder, lodging formal complaints with the State Office of Procurement.

LHCC contends it is inexplicable that its participation would be terminated at the end of the year because it has amassed an exemplary record with Louisiana since first winning a contract under the administration of Gov. Bobby Jindal in 2012.

“You wonder, what’s the reason? Where is this coming from?” said Randal Johnson, a strategic consultant working with LHCC. “It has to be something untoward.”

It was in fact in order to trim costs and improve care that the Edwards administration announced it would seek new bidding on the contracts this year with the new situation to go into effect on Jan. 1, 2020.

After some delays, the administration announced last month that it would contracts with four NCOs instead of five, LHCC being the one cut out.

Mr. Abraham contends it is also telling that, in response to public records requests filed for documents related to the new bidding and decisions, Mr. Edwards’ staff said they would likely not be available until Oct. 14 — two days after Louisiana voters go to the polls in the jungle primary round of the governor’s race.

That date has now been extended even further, to Oct. 17, Mr. Johnson said Monday.

LHCC lodged its formal complaint Aug. 19.

“This process was never fair,” its attorneys wrote. “Rather, it was tainted with conflicts of interest and bias from the start.”

In the complaint, LHCC highlights internal communications between Department of Health staffers that is says reflects animus toward LHCC. For example, following a regulatory ruling against it LHCC contends cost it $10 million, last year the state ruled against the company in a ruling it said cost it $10 million, some state staffers rejoiced.

After communicating that decision, a state worker emailed one of LHCC’s competitors, “I thought I heard an explosion!!:)” and a smiley emoji.

Similarly, when LHCC’s appeal on that ruling was rejected, the LDH executive who made the decision emailed colleagues a drawing of a woman dropping a microphone to which one responded, “LOL.”

“The expression of glee on having imposed a harsh decision on LHCC reflects a striking level of animosity and hostility toward LHCC: one wonders what emotion she might have expressed after LHCC’s bid was denied here,” the complaint states.

For now, all sides are awaiting a ruling later this month from the state’s procurement office. In the meantime, Mr. Abraham said the Edwards’ administrations decisions and delays fail to pass the smell test.

With the federal portion of Medicaid payments under Obamacare expansion falling next year, Louisiana’s situation will only grow more dire, he said.

“The dishonesty and lack of transparency from the governor…is appalling and unacceptable,” Mr. Abraham said. “Finally, what might be the worst of all, is the political retribution of this administration.”