New Orleans, La. -- Some local doctors say the state's latest Medicaid crisis could force them to shut down their medical practices.
A surprising piece of legislation on Capitol Hill has the state looking for ways to cut nearly $1 billion from its Medicaid program, which provides health coverage for the poor.
"Give the immunizations to the child in Room 2, please," Dr. Richard LeBoeuf told a nurse in his Metairie office Tuesday.
He has dedicated his career to keeping children in this area healthy. But in recent years, dedication to his life's work has come at a great financial sacrifice.
"We're going down hill at the moment," he said.
Dr. LeBoeuf treats Medicaid patients. He shares the practice with Dr. Floyd Buras.
"It's a very rewarding thing to do. Both of us love what we do and we wanted to keep doing it into the future. We've taken care now of third and fourth generations," LeBoeuf said.
But the latest blow to the state's Medicaid program may change their plans to keep at it.
"Neither one of us had plans to retire, or the wherewithal to possibly do so, but the current climate may force us to do so," he said.
What happened in the U.S. Capitol last week has injected financial chaos into the state's nearly $8 billion Medicaid budget.
Members of Congress honed in on a provision added to the health care overhaul law by Sen. Mary Landrieu, D-La., that was designed to protect Louisiana from a Medicaid rate drop because of the flood of recovery dollars it received after hurricanes Katrina and Rita. An error in the writing of the provision sent millions more to the state than what was initially expected.
So House members used the federal transportation bill to reverse the error, dropping the state's federal Medicaid match rate. That has resulted in an unexpected $859 million hole in the Medicaid budget -- roughly 11 percent -- and the need for more cutbacks, which could affect the reimbursement rate for doctors who treat Medicaid patients.
"The total reimbursement isn't there at the moment, and they're talking about further cuts," said Dr. LeBoeuf.
Department of Health and Hospitals Undersecretary Jerry Phillips said, "We are currently working on a plan with the Division of Administration to meet the reductions set by Congress. At the end of the day, DHH will have a balanced budget."
Congressman Steve Scalise, R-Metairie, says he is frustrated by the developments.
"I am disappointed that House and Senate leaders included a provision in the bill that takes FMAP funding already budgeted for Louisiana and spends it on unrelated transportation projects," he said.
"We've been letting nurses go. Cutting back hours, and trying everything we can do to survive," continued LeBoeuf.
Funding for the state's public hospitals, which serve the uninsured and underinsured, could also be slashed.
"Maybe they're going to achieve their goal of not spending so much, but I think it's going to be a disaster," added LeBoeuf.
He said, as more and more physicians grow tired of the Medicaid funding problems, the poor will suffer.
"We're not sure who's going to be able to continue to practice, and the problem is going to be who's going to take care of these people," said LeBoeuf.
DHH says about 1.2 million Louisiana residents get some health care coverage from Medicaid, most of them children under the age of 19.
Dr. Richard LeBoeuf inside his Metairie office.
