The Jindal administration took a different course than other Republicans. Jindal withdraws Obamacare request

Gov. Bobby Jindal, a fierce Obamacare critic, pursued funds from an under-the-radar program in the health law until this week, when his administration reversed course, citing cumbersome federal rules.

Health aides to the Louisiana governor began eyeing the program – a long-term care reform effort called Community First Choice – last year and went as far as submitting a formal application to CMS. But officials say they withdrew the application Monday because complicated federal stipulations would have undermined their efforts and likely led to lawsuits.


And Jindal’s not the only prominent Republican governor to take a look at the program. Fellow Obamacare foe and 2016 talker Gov. Rick Perry has also sought cash from the health law initiative, defending that decision Tuesday as the right policy move for his constituents.

( PHOTOS: Bobby Jindal’s career)

The Jindal administration took a different course.

“This is a great example of an area where [CMS] wasn’t being flexible to work with the states to make it work for us,” said Calder Lynch, policy director for Louisiana’s Department of Health and Hospitals. “If CMS changes its position in a way that makes sense for Louisiana, we would revisit it. At this time, we haven’t seen any indication of that.”

The program boosts states’ Medicaid match rate by 6 percentage points for certain long-term care services for the elderly and disabled, encouraging community- or home-based care for thousands of Medicaid-eligible patients.

“After consultation with CMS to better understand the statutory provisions that states are required to meet, Louisiana decided to withdraw their current CFC application,” CMS spokesman Brian Cook said. “However, the state is welcome to resubmit their application for the CFC program at any time.”

Lynch said the program would force a “vast expansion” of community care services and would have overwhelmed the state’s existing infrastructure. Not to mention, he said, it would open the state up to “lawsuits which we feared would’ve resulted in us having to offer … care to far more individuals.”

( Also on POLITICO: Texas Gov. Perry seeks cash from ACA)

The reversal also sidesteps a tricky political situation for Jindal, who as chair of the Republican Governors Association and a potential 2016 presidential contender, has railed against Obamacare on a national stage. Accepting Obamacare funds, even from a less controversial aspect of the law, could be viewed as at odds with his blanket calls for eliminating it.

“The Obama team … foisted upon the country a liberal hodgepodge of unworkable notions that will wreak havoc on American health care,” Jindal wrote in a recent Wall Street Journal op-ed, co-authored by Wisconsin Gov. Scott Walker. “Delaying implementation of Obamacare … is a reasonable idea. But an even better one would be a complete repeal.”

About a dozen states, mostly led by Democratic governors, have pursued the Community First Choice program. But solidly red state Arizona — in addition to Texas — had expressed interest too.

( Also on POLITICO: The swing states of Obamacare)

Lynch said the Jindal administration reviews every health policy program separately, regardless of whether it originated in Obamacare. “This was a piece of it that was considered entirely separately from other aspects of the law,” he said.

But at least one local advocate for community care saw “political gamesmanship” in the Jindal administration’s decision to withdraw.

“You can’t rail against the Affordable Care Act at every opportunity and then clandestinely, selectively apply for different pieces of funding for it,” said Moriba Karamoko, founding director of the Louisiana Consumer Healthcare Coalition.

( PHOTOS: 25 unforgettable Obamacare quotes)

Karamoko said Jindal’s reversal appeared to be a face-saving move politically but also a nod to the state’s powerful nursing home lobby. “It’s human lives that are left in the balance around it,” he said.

Although Louisiana is no longer pursuing Community First Choice funds, it has already been approved to receive another, more modest stream of Obamacare cash.

The state is one of 16 authorized to receive a cut from the $3 billion Balancing Incentive Program, an Obamacare initiative that offers more generous Medicaid funding to states that “make structural reforms to increase nursing home diversions and access to non-institutional [long-term care services].” Mississippi, Georgia, Texas, Indiana and Maine - states whose governors have been hostile to the health law - are also among those receiving funding for that program.