(WVUE) - The two candidates for governor in Louisiana both say they have the right prescription for fixing what ails the state. Recently, they spoke of their stances on expanding Medicaid. Under the Affordable Care Act, states are asked to increase the number of people who would qualify for Medicaid, but Gov. Bobby Jindal has refused to do so, arguing that the state would be burdened with tremendous costs in years to come.
Republican Sen. David Vitter is in a runoff with State Rep. John Bel Edwards, a Democrat.
"We have very different ideas about Medicaid expansion," Vitter said.
Edwards is a strong supporter of expanding eligibility for Medicaid as the federal health care reform law. It designed to benefit people who make too much money to currently qualify for Medicaid, and too much money to get federal subsidies to purchase their own health insurance.
"I think we ought to put our working poor people first," Edwards said. "These people don't qualify for Medicaid today precisely because they work, but they don't have health insurance coverage because they don't make enough to buy it, and their employers don't offer it.
According to the U.S. Department and Health and Human Services, an additional 265,000 people in Louisiana would get health coverage if Medicaid eligibility requirements were expanded. The federal government is paying 100 percent of the costs tied to expansion for the first three years, and vows that federal funds would never fall below 90 percent in the future.
Vitter does not rule out Medicaid expansion should he win the governorship, but with plenty of strings attached. He wants to overhaul the state's Medicaid program, he wants a plan for hospitals to help with the state's matching fund, and he wants to require that people who benefit from the expanded coverage have employment.
"I would only consider an expansion if we do it on Louisiana terms, not the federal government's terms, not Barack Obama's terms, so I would only do it if we had a negotiation with the federal government, and we met all the important criteria to protect our interests here in Louisiana," Vitter said.
"With the amount of money on the table, both candidates, John Bel Edwards and Vitter, [are] willing to accept the money, the nuance is under what conditions," said FOX 8 political analyst Mike Sherman.
Edwards said hospitals are bleeding money in terms of uncompensated care of the uninsured.
"Our hospitals need reimbursement for the care that they provide. Maintaining the status quo is not possible," he said.
But while hospitals would benefit from having more people insured, how will the candidates' stances on the expansion of Medicaid play with voters?
"It's something that the hospitals have been very supportive of, but the core conservative base who's completely against Obamacare, completely against the Affordable Care Act, has not been kind to governors who have taken this money," Sherman said.
Vitter said some states who have expanded Medicaid are finding they underestimated the costs and now face serious budget issues.
"That has led to tougher budget times in many states, for instance in Kentucky, they under-estimated what that would cost in terms of state dollars, and the true cost is over double what they thought," Vitter said.
"We would have saved $52 million this year alone by expanding the program," said Edwards.
The election is Nov. 21.