FOR IMMEDIATE RELEASE
2/04/10
Landrieu Floor Speech on the "Real Story" Behind $300M Medicaid Fix for Louisiana in Senate Health Bill
WASHINGTON — U.S. Senator Mary L. Landrieu, D-La., went to the floor of the U.S. Senate today to outline why she fought so hard for the inclusion of the $300 million Louisiana Medicaid provision in the Senate health care reform bill. Landrieu refuted misinformation being spread by opponents of the bill and disclosed the details of the multiple requests made by Louisiana’s Republican Governor, Bobby Jindal -- from the first meeting at the Governor’s Mansion to its inclusion in the Senate health care bill.
Sen. Landrieu said:
“Thank you. I thank the Senator for yielding his time. He has an hour under his control and I intend to take the full measure of the hour that is left speaking first in favor of the nominee that he has so eloquently he described in terms of background experience and the arguments that he's making about trying to bring more civility and bipartisanship to this body. And the importance of getting some of these very important federal officials appointed so that government can work better, more efficiently. It's been my pleasure to serve with the chairman now for several years on the homeland security committee, and I'm familiar with the work that he and his ranking member, Susan Collins, the Senator from Maine have done together. They have shown a real example of bipartisanship, and I would hope that his calls for this nominee to move forward and be taken up without delay will be heeded.
“I'm on the floor to speak about a different subject, one that is very, very important to the state of Louisiana and the people of our state. And an issue that has been mischaracterized for months now in all sorts of venues, and I thought taking an opportunity today for a couple of hours to go through the request by the state of Louisiana for a change or a realignment of our FMAP formula, the formula that funds our Medicaid system would be a good thing to do.
“It's a good thing for several reasons. The most important of which is not to bring up this subject again for further review, to try to clear anything that people have said about me. I've been in public office now for 30 years. People have said all sorts of things about me as a public official. I would venture to say that every member of this body has been called some very choice names. That is actually not why I'm here to defend myself. The record will do that.
“What I am here to do is defend the people of Louisiana and to express clearly and strongly why and how our delegation came forward united in a very public way to press our case here in Washington, the only place that this can be fixed. Why we felt as a delegation strongly united, Democrats and Republicans, to press this case to the federal government to get some immediate and necessary and urgent relief for the people of our state.
“I make no apologies for leading this effort. I do not back up an inch from the year-long effort that we have undertaken. And I'm here today because I actually don't have any idea at this moment what will happen to the health care bill that we have worked on for the better part of a year.
“I don't know if we're going to have a bill. I don't know if it's going to be the senate version or the house version. I don't know if it's going to be a bill passed by 60-plus or more people on the senate side, and a wide majority in the house. I don't know if there is going to be reconciliation that's used. Those discussions are happening actually, right now above my pay grade. But what is in my pay grade, what I actually do get paid to do here is to represent the people of Louisiana, and I intend to do that for the better part of this hour and for the rest of the day, because there's been some great misunderstanding about this in the national media. Not much in the mainstream media, but on the fringes, but sometimes those fringes can be quite loud. And I'd like to try my best to silence them a little bit at this point.
“The mainstream media has been, for the most part, taking their time to understand it. And I appreciate it. And I certainly appreciate the newspapers in my state who actually know more about this than any media outlets. They would because hey have covered it longer and have editorialized it generally in my favor and the favor of our delegation that has stood strong except for two members that have folded on this issue.
“So I want to start and I'm going to try to just take everyone through the, chronologically, the time frame. First of all, I have been, and the state of Louisiana has been, criticized for a secret deal, for something that happened at the very end of the process that people didn't really know about. I’d like to call everyone’s attention to a Times-Picayune headline—it’s a newspaper in New Orleans—a Times-Picayune headline dated January 11, 2009. Now, we're in February of 2010.
“So this was a year ago. This was a year ago. I also would call the attention to my critics that this date is actually almost two weeks before President Obama was ever sworn into office. Just to remind people. This meeting called by my governor, who's a Republican governor, happened in a public place in the governor's mansion in Baton Rouge and five members of our delegation were there and the entire delegation was represented. It is reported, at length, in several papers. This, The Times-Picayune, this is the headline, “Jindal reviews wish list for Louisiana delegation; aid for recovery, health care stressed." This is the other headline, "Governor Jindal stresses urgent need for federal government to fix faulty FMAP rate.” Let me repeat that, "Governor Jindal stresses urgent need for federal government to fix faulty FMAP rate." Not “special FMAP rate,” not “FMAP problems that every state is fixing,” but “faulty FMAP.” And I will explain why we think it's faulty in a minute.
“The Advocate, August 29 – these meetings continued through the year – Jindal, Republican Governor, Landrieu, Democratic Senator, pushed for federal funding fix. So I just want to put my critics on notice, and I'm going to submit letters, and documents, and these articles. Nothing about this effort was secret. Nothing. And if there is one member of this body, either the junior Senator from Louisiana or the great Senator from Arizona or any other Senator that would like to come and talk to me about this “secret” effort, I would look forward to hearing your comments on the floor of this senate sometime today, because I'm staying here until 6:00 or 7:00, until we go out of session tonight.
“I thought it would be good to spend the better part of the day. If anyone, any Senator wants to come down and say that they thought this was some kind of secret arrangement, I think the editors of our newspapers would be very interested since they have been reporting on it since the first meeting on January 11, 2009.
“Secondly, I would like to show a letter signed by our entire delegation to make another point. My critics have said: “Oh, there she goes again. Senator Landrieu just running off on her own, making all sorts of terrible things and making the state of Louisiana look bad.” I have spent 30 years of my life trying to represent the people of my state and make them look good. Even when they were wrong, I have defended them, and when they were right, I praised them. And when I was wrong, I apologized, and when I was right, I was very proud of my work.
“Never, never in my life have I ever or will ever throw the people of my state under a bus to save my reputation or my job. I know what I am inside. I don't need anyone to remind me of the goodness that I have inside. My parents do that, my husband does that, my children do that for me every day. And I don't most certainly need anyone, and I don't need this job badly enough—maybe some people do, I don't—to throw the people of my state under a bus to protect myself politically.
“I want to show everyone a letter on May 4, and I'm going to read every single signature, because I'm actually proud to lead this delegation. I only have one Democrat besides myself, but other than about one member of this delegation, we have some pretty extraordinary leaders, and I'm proud of them. And they are very conservative and some are very liberal and some are in the middle, and we have a very diverse delegation.
“I signed this letter. Rodney Alexander signed this letter—he’s a member of the Appropriations Committee. Charlie Melancon signed this letter—he’s a member of Congress. Bill Cassidy is a member from Baton Rouge, David Vitter, the junior Senator, Charles Boustany from Lafayette, Steve Scalise, from Jefferson Parish and John Fleming from Shreveport, and Joseph Cao, the newest member, Vietnamese-American member of Congress, from the New Orleans area signed this letter.
“This was made public, actually, some members put out their own press releases, and the letter basically says, to Secretary Sebelius, who was finally sworn in after being held up for months when she finally got in office.
“‘We write you today to follow up on an April 9 letter. Your office received Louisiana secretary Alan Levine."—that's our secretary—"while many states will face challenges to their Medicaid program in the coming years, we believe that Louisiana's case is unique."
“’We believe Louisiana's case is unique. As you may be aware, our state is still rebuilding from hurricanes Katrina and Rita in 2005, as well as Hurricanes Gustav and Ike in 2008, including the rehabilitation of the health care system in the New Orleans area. These extensive recovery efforts have inflated Louisiana's per capita income, but they were only temporary, and do not actually reflect the increases due to incomes and industry not related to the hurricane recovery. Since the FMAP formula per capita to calculate how much each state will receive, we are greatly concerned that the post-hurricane per capita income increase would significantly impact our FMAP allocation. We ask that you meet with Secretary Levine to develop a solution to the unique problem that our state is facing.”
“This is an example of one letter. I have many others, signed by our entire delegation, asking the officials up here, from the white house to Kathleen Sebelius to other powerful members up here to please look at Louisiana's situation, because ours alone among the 50 states was unique, and I'll explain why in a minute.
“So the fact that this was secret is a lie. The fact that it wasn't supported by our delegation is a lie.
“And now I want to explain what our problem is, and this map explains it, or chart, better than I could. As anyone knows how this federal formula works for Medicaid, Medicaid is a voluntary program to a certain extent that states can enter into to cover their very poor. The federal government says if you want to do that, if you're a wealthy state, we will pick up50% of your effort. If you're a moderately wealthy state, you know, we'll pick up 60% of your effort. And if you're one of the poorer states in the union -- not that Louisiana isn't an extraordinary state—but we have high poverty relative to other states, just like Mississippi and Alabama, West Virginia… We know who our cohorts are. We have been at this a long time. And for us, the federal government says if you try to cover your poor, we will pick up 70% for you, which is the right thing to do. The federal government should help the poor states a little bit more than the wealthier states. It's actually what's taught in the bible. I wish we would follow it a little bit more around here.
“But anyway, so for years this is what's occurred. 1999, the federal government paid 70 cents of every dollar. You can see basically, and it's done by an income calculation, because our income, we have gotten a little bit richer here you can see, a little bit richer, a little bit poorer, but a little bit richer.
“But all of a sudden, because of a unique set of circumstances that happened because of Katrina and Rita and Ike and Gustav—not because of any politics up here—but because of hurricanes and levee breaks and a catastrophic flood and an influx of federal dollars that came to help, which we're grateful for, our congratulations were terribly distorted and skewed when the new calculation was made, and as a result, ours would have fallen -- the federal government's portion would have fallen—to 63%.
“So from an average of about 70%, we would have fallen to 63%. That doesn't sound like a lot, but it would have meant about a $400 million to to $600 million -- I will give very rough -- $400 million to $600 million difference, and either the people of my state would have had to cut $400 million to $600 million out of programs today or they would have had to raise $400 million to $600 million in taxes.
“That's a lot of money, even here in Washington where we throw around a billion dollars and a trillion dollars like it's nothing. I can promise you there are people sitting around their kitchen tables in Louisiana, way down in Thibodeaux and way up in Mansfield, Louisiana, thinking, “where are we going to come up with $500 million? This is -- this is terrible, Senator. We didn't do anything. We're not that much richer. We're actually still struggling from the recovery. Doesn't anyone in Washington understand that we did not get an -- we are not 40% richer than we were two years ago? Does anybody know up there that we're still struggling with this recovery?” And I assured them I knew, and our delegation knew, and that I knew some people that might be understanding. I mentioned to them actually that I would bring this to Harry Reid, I said, because he is a good man, he has a good heart. And I think if I explained this to him and to kathleen Sebelius, who is a very good secretary, and get their staffs to look at it, perhaps they would agree with us that we needed some special assistance.
“And I thought there might be one person, one person with a heart on the other side of the aisle. I still think there may be. But I said, you know, let's just try. So our delegation went to work. And lo and behold, we have a health care bill coming along. It's a bill that some people like and some people don't, but it is most certainly germane to my subject. It is most certainly germane to my subject. So I say this is nice. I know we're going to be on health care. Let's see what we can do to get this in this health care bill. I don't know what the bill is going to look like. I don't know if I can vote for it when it finally comes. I don't even know if I’m going to be for it, but it's a health care bill, this is the health care amendment.
“Some people have actually criticized me recently and said, “you know, the Senator put it on the wrong bill.” “The Senator discussed this at the wrong time.” “The Senator has ruined the efforts of the state to get help because she asked for this amendment.”
“Was I supposed to ask for it on a transportation bill? Was I supposed to ask for a Medicaid fix on a jobs bill? Was I supposed to ask for it on a lands bill? You know, forgive me for asking for a health care amendment on a health care bill.
“So I did.
“We pursued it openly. We pursued it bipartisanly, and we pursued it intelligently and smartly on the health care bill. And I assured my Republicans privately and publicly: ‘I know you're not for the bill. You don't have to vote for the bill. I may not vote for the bill.’ I didn't know I was going to vote for the bill until the very end, and I’m going to talk about why I decided to vote for the bill. I said: ‘but no matter how we vote on this bill, let's really make a case as strong as we can that this should be fixed.’ And we basically agreed to do that, and the record will show that.
“So at some point later as the debate moved over here to the senate, I was asked to present on any number of occasions just like every Senator here was asked, what are the things that you think are the most important in this health care bill as we begin the debate. I wasn't on the Health committee. I'm not on Finance. So those of us not in HELP and not on the Finance committee submitted our documents which I’m going to release today to the leader and said, ‘these are the things that we think are most important.’ This was always on that list.
“I'm proud that it was on the list, but what I want people to realize is it wasn't the only thing on the list. It wasn't the first thing on the list, and it wasn't on the list in any letter or correspondence that said, ‘if this doesn't get on, I’m not voting for the bill.’
“In every correspondence, public, in every public meeting and every private meeting, I pressed for this issue, but never did I say at any time that if this wasn't in the bill, then I wouldn't vote for it or if it was in the bill, that I would vote for it, because I don't believe in that. As strongly as I feel about this provision and the merits of it, I would never have asked my colleagues.
“I did ask my colleagues to understand a few other things, and they can tell you that I said this in any number of meetings, and unfortunately some of them were locked up with me for days, so they actually got to hear this over and over again.
“I said, ‘I cannot vote for this bill unless it drives down costs. I cannot vote for this bill if there is a government-run public delivery system. I will not vote for this bill if there is an employer mandate. I can only vote for this bill if it extends coverage to people that don't have it in a way they can afford it where they have choices in the private sector.’
“I said that speech a hundred times in my state. I was on the radio. I have been here on this floor. My colleagues have heard it any number of times, and I said to my colleagues, ‘if you're going to cover children who can stay on their parents -- cover them through their parents' insurance, if the underlying bill, whether it comes from the senate or the house, is going to cover children up to 26 years old,’ which is a very good reform, something I think the American people support, most certainly the people in my state would love to be able to keep their children on their own health insurance until they are 26. I said, ‘I would be hard pressed to vote for a bill if you left out children that don't have parents.’ Since I’m the co-chair of the adoption caucus and the co-chair of the foster care caucus with Chairman Grassley, I felt very empowered to speak those words to those leaders here.
“Because my job -- part of my job I’ve taken on myself is to try to represent children in foster care. I don't do a very good job every day and sometimes I don't do the job I should do for them. But I try my best and when we're in those meetings, they have no one speaking for them. They most certainly don't have any money to hire a lobbyist. They most certainly have no parents here advocating for them. Every now and then I’ll speak up for them – and I wish I'd do it more – and so I said, ‘I really, if you're going to put that in the bill so that every child in America gets stay on their parent's health insurance until they're 26, do you all realize that we have 22,000 children that graduate and come out of our foster care system that don't have any parents? So what are we going to do for them?’ And they said we don't know, we think we'll just leave them out. And I said, ‘I don't think you will, because if you really want my support for this bill, that has to be in there.’
“Now, I said that on the floor, I said it in meetings. This was not in that conversation. This was: we need it, we believe that we have a $400 million $600 million fix. We'd love you to fix it all, we'd love the full $600 million, but we'd appreciate whatever you can do to help us. And, frankly, the reason we should fix it not only will it be good for Louisiana but by chance, if any other state, when the earthquake hits Memphis, it will someday, and when the earthquake hits California -- it will someday -- you know what? If this is in the law, they won't have to pay double for their Medicaid three years after that disaster, because there will be this adjustment that says if your rates arbitrarily or artificially are distorted by the fact that you've got an increase in public assistance coming in to your state, we won't count you as having a 40% increase in income.
“And it will help, contrary to the Senator from Arizona. It doesn't just affect Louisiana. For the time being it does, but in the future it would affect a lot of other states, and that's the right thing to do. Because nobody should be punished for having a disaster. Why would you punish?
“This money, this $400 million, is to protect the poorest children in my state; Children who lost their parents in the flood, their grandparents in the flood, children that lost siblings in the flood, children that are still not back in their houses. Why would we punish these children, these disabled people, the poor people on Medicaid because the federal government's levees broke? Why would we do that?
“I don't think we want to.
“So I’m not going to stand by silently while the people of Louisiana are criticized for asking for something in a public way, describing our situation, expressing that we are unique among the states in this and asking for assistance. I think the White House understands this. I know that Kathleen Sebelius understands this. I'm most certainly confident that the leadership on the Democratic side.
“I'm very interested in what the Republican leadership has to say about this. They have been very quiet. And if this isn't the place to ask for it, Mr. President, where is the place? Because I'd like to go. If this isn't the time to ask for it, what is the time? Because this budget is being crafted right now by my legislators. Not two years from now, right now. And they're either going to know that they have $350 million to work with or they're not. They're either going to raise $350 million on the backs of my people that can hardly pay the taxes they're paying now, or they're going to cut off some more either elderly or the poor or the disabled who rely on Medicaid. So if this isn't the time, when would I come?
“Now, to close, because I have just a few more minutes, I'm going to read the one statement that my governor has made publicly on this for the record.
“You know, being in public office takes more than being intelligent, it takes more than being a fancy resume; it takes guts. Some people have more of those than others.
“This is what my governor said, on November 20 to CNN: ‘The bill is awful, but it's unfair to criticize Senator Landrieu or the rest of our delegation for fighting to correct this injustice to Louisiana. Our entire delegation is working together across party lines to correct this flawed formula.’
“This is the one statement that he made.
“So I’m going to—I see my colleague on the floor to speak about other matters—I'm going to rest for a moment, but I’m going to be on this floor until 6:00 today. I'm not leaving. And if any Senator from the Democratic side or the Republican side wants to debate me on any aspect of this, I would kindly ask them to let's get this over with today. So I will look forward to seeing them. I will be here until 6:00. And if they don't come, then I would hope that they would keep their mouth shut about something they know nothing about. Thank you.”