Bad Faith Offer

Snakes alive, Bobby Jindal is a busy man these days! Even as pundits are still debating his Great Big Speech to the winter meeting of the Republican National Committee last week, here he comes again with a WaPo op-ed demanding that the president give governors like him unprecedented power over the Medicaid program.

Bobby modestly doesn’t mention his famous appointment at the age of 24 as administrator of the Louisiana agency that administers Medicaid. But he gets pretty condescendingly preachy anyway. And if you haven’t been paying attention to Medicaid politics for the last couple of decades, you might not recognize the code Jindal is using:

[A]fter nearly a half-century of running this program, states know its problems and how to address them.

A number of Republican governors have asked to meet with President Obama to discuss their solutions, but the White House has ignored these requests. The president claims that he wants to work across party lines to get things done for the American people, so perhaps he could start by meeting with Republican governors who want to solve our nation’s health-care problems.

Our ideas to fix Medicaid target several areas for reform: eligibility, benefit design, cost-sharing, use of the private insurance market, financing and accountability.

Eligibility refers to the Republican desire to de-qualify major categories of Medicaid beneficiaries. Benefit design means fewer benefits. Cost-sharing means charging beneficiaries sufficient deductibles, premiums and co-pays to discourage them from accessing medical services. Use of the private insurance market means what it says, and is based on the increasingly untenable theory that private insurance is cheaper than public insurance. Financing and accountability means Bobby and his friends want carte blanche to do what they want with Medicaid, without having to go to the trouble of applying for waivers to break the law (Medicaid is already far and away the federal-state program most liberal with state waivers).

Beyond the expert-sounding mumbo jumbo in Jindal’s op-ed, there is the sheer audacity of him demanding Medicaid concessions of the president when he is in the very midst of obstructing the implementation of the Affordable Care Act his state, refusing to participate in either the ACA’s Medicaid expansion or the establishment of health exchanges. And if that were not enough to indicate his bad-faith-offer to work with the Obama administration on “Medicaid reform,” there is his Great Big Speech in Charlotte, in which he argued that Republicans should go through every domestic government function and either abolish them or hand them over to total state control via a block grant.

Methinks Jindal should have waited a bit before posturing as the savior of Medicaid.

Ed Kilgore

Ed Kilgore, a Monthly contributing editor, is a columnist for the Daily Intelligencer, New York magazine’s politics blog, and the managing editor for the Democratic Strategist.