Top House Republican Endorses Medicaid Expansion

July 9, 2013 9:20 a.m.

A powerful Republican congressman from Louisiana wants his state to take up the Medicaid expansion made optional by Obamacare and build an insurance exchange to implement the law, breaking with his GOP governor and conservatives on an explosive issue.

Rep. Charles Boustany, the chairman of the Ways and Means subcommittee on oversight, told constituents last week that if he had his way, Louisiana would accept the offer under the Affordable Care Act and reform Medicaid into a “21st century program,” according to the The Daily Advertiser in Lafayette.

Speaking and taking questions after a lunch meeting at the Rotary Club of Lafayette North, the congressman (and cardiovascular surgeon) also said Louisiana should build a state-based insurance exchange. He reportedly argued that failing to do so — which would relinquish the task to the federal government — would make it harder for Louisianans to receive tax credits for insurance.

“It could put Louisiana in a very bad place,” Boustany is quoted as saying. “To sit back and do nothing is not an answer.”

He allowed that the Affordable Care Act was flawed and “rushed through.” He has led some efforts to needle the Obama administration over implementation of the law.

TPM reached out to Boustany’s communications director and counsel Neal Patel on Monday to follow up. Patel initially replied that the Daily Advertiser article “didn’t accurately reflect his views” and offered an interview with the congressman to explain his stance. Hours later, Patel canceled, citing scheduling issues and not offering another time to do the interview. TPM asked twice for a statement clarifying the congressman’s views, if in fact they were misrepresented, but Patel declined to provide one.

First elected in 2005, the congressman is reportedly close to Speaker John Boehner (R-OH), the face of GOP opposition to Obamacare. He represents a conservative district along the Louisiana Gulf Coast. He won reelection in 2012 in a runoff against then-Rep. Jeff Landry (R), a tea party incumbent, after Landry and Boustany were redistricted into the same district.

The Medicaid expansion stands to significantly benefit Boustany’s constituents — and at very little cost because the federal government would foot the entire bill for until 2016 and 90 percent thereafter. At least one in five Louisianans are uninsured and the expansion is projected to cover some 400,000 state residents.

As a leading member of the Ways and Means Committee, Boustany oversees issues important to health providers, which are strongly supportive of the Medicaid expansion. Hospitals in particular have lobbied aggressively for it, fearing that the cost of uncompensated care could skyrocket if too many Americans are left uninsured.

“I won’t speculate on Boustany’s motivations,” said a Democratic operative based in Louisiana. “He is a doctor, so that may inform his opinions. I will note that many Republican governors, including Jan Brewer, John Kasich and Terry Branstad, have seen the light on Medicaid expansion. It’s a shame that Bobby Jindal did not. He put his political ambitions before what’s best for the people of Louisiana.”

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