Medicaid vouchers could get new life in Louisiana

Physicians want to add their views to state discussions on how to reform the health care system.

By Joel B. Finkelstein, AMNews staff. Nov. 15, 2004.

Washington -- Louisiana physicians plan to draw renewed attention to a Medicaid reform strategy that failed to take hold during the 1990s but that might help the state's low-income patients.

At the beginning of the year, the state's governor, Kathleen Blanco, launched a health care reform panel tasked with addressing several problems, among them a relatively high percentage of uninsured people and increasing Medicaid costs.

Physicians are determined to be a party to those discussions. They have launched an effort to look at reform strategies, starting with a Medicaid proposal originally introduced by the Louisiana State Medical Society that led to successful legislation in 1995. The plan was to create a pilot project that would give out Medicaid vouchers allowing recipients to receive the traditional state-run benefit or "purchase" coverage through managed care companies. It also included a buy-in option that allowed low-income residents who didn't qualify for Medicaid to purchase coverage through the program.

But the Louisiana Dept. of Health and Hospitals decided to first implement a tandem pilot project proposed by the managed care industry. When that strategy failed, the department dropped both, without trying the physicians' plan. "The administration did not like our proposal, and they didn't do it," said Dave Tarver, LSMS vice president.