Politics & Policy

Obama’s War on Louisiana

The latest attack is against the state’s hospitals.

If all who love liberty are rightly upset by an administration’s harassment of conservative groups for political ends, we should be even more outraged when the administration, while playing political hardball, mistreats an entire state’s ordinary, apolitical citizens.

From the earliest days of his presidency, Barack Obama has shown a particular animus against Louisiana governor Bobby Jindal, and has repeatedly held Louisiana citizens hostage to that animus. The latest outrage came via a May 2 letter from the national Centers for Medicare and Medicaid Services (CMS) disapproving Jindal’s brilliant semi-privatization of state hospitals that, in less than a year, already has resulted in better patient services across the board – thus putting at risk hundreds of millions of dollars in ordinary federal reimbursement for indigent care.

We’ll return in a moment to a few more details of this latest cynical maneuver. First, though, consider the litany of Obama’s abusive treatment of Louisiana; the Bayou State is surely the jurisdiction most victimized by the Obamite combination of wrath and pettiness. It began early, after Jindal’s (poorly received) 2009 State of the Union response, which represented the first major high-profile critique of Obama’s gauzy new administration. Clearly, Jindal got under Obama’s skin.

Just two months later, the Obama team was notoriously slow to respond to the massive Deepwater Horizon oil spill. Among a host of mistakes documented by a national commission on the disaster were clearly politicized decisions on numerous fronts, including on the allocation of oil-containing booms. Worse (and despite some media fact-check reports to the contrary), the Obama bureaucracy kept obstacles in place that blocked specialized foreign skimmers from helping to contain the spill — in part, it seems, to placate American unions.

President Obama’s most public early response to the crisis was to ostentatiously upbraid Jindal for supposedly politicizing the problem. (Jindal had sent the administration a letter that was actually a routine administrative matter.) The administration followed by implementing a moratorium, and then “permitorium,” on drilling in the Gulf, doing serious harm to Louisiana’s economy — and continued the slowdown in such contradiction to court rulings that a federal judge found the Obama team officially in contempt of court.

Since then, the administration’s battles against Louisiana have been almost unrelenting. They have been combined with national policy decisions, such as the blow to Louisiana refineries from Obama’s refusal to approve the Keystone pipeline, that have hurt Louisiana worse than most states.

Probably the most destructive, even malevolent, example of harassment came in Obama’s suit attempting to block the widespread school-voucher program Jindal had implemented. Parental satisfaction with the program has been astonishingly high, surpassing even the highest expectations of most voucher advocates, but the Obama Justice Department has tried several different legal means to prevent parents, mostly black, from having educational choices for their children.

That wasn’t the only Obamite attempt to misuse the courts. In its bloodlust to nail New Orleans cops for what almost certainly were inexcusable shootings in a bridge incident six days after Hurricane Katrina, Obama Justice Department officials not only countenanced an illegal blog campaign to poison the well but then deliberately helped cover up its involvement. A federal judge, appalled by the corruption, felt obliged to throw out the convictions and order a new trial, writing that the misconduct was so great that “there is no case similar, in nature or scope, to this bizarre and appalling turn of events.”

If that case seems a bit remote from direct Obama involvement, the president’s response to Hurricane Isaac in 2012 clearly was a personal call. As I reported at the time, Obama refused to provide fairly routine Stafford Act relief to Louisiana’s storm victims — in direct contradiction to a fiery post-Katrina speech in which he indicated that such money should be virtually automatic.

All of these major actions, plus a number of smaller ones, indicate a toxic attitude toward Louisiana — or perhaps toward Jindal, with Louisianans treated as collateral damage. With Jindal having so loudly led the charge of governors refusing to accept Obamacare’s expansion of Medicaid, the stage was set for Obama’s team to extract payback, especially via federal health-care payments.

Hence the new outrage:

Louisiana for decades (in one case, centuries) has run a unique system of “charity hospitals,” and Jindal has been working to reform the system for years. When the feds in 2012 cut the percentage of some federal matching funds, Jindal was faced with a sudden budget shortfall. He responded by leasing out the hospitals to private managers, thereby relieving the state of direct management burdens while bringing in a steady stream of revenue. The leases were structured with extra-large “advance payments” in the first year, much like a down payment on a home or an extra month’s payment from a house renter.

In less than a year, the hospitals opened more beds for the mentally ill and in emergency rooms, provided more advanced technology for cancer screening and other care, and began improving services across the board. Already the Jindal reforms were providing proof of his (and other conservatives’) longstanding contention that state innovation could do far more to deliver better care, more efficiently, than a centrally regulated federal behemoth can.

That success may have been more than the Obamites could bear. At first, the feds seemed satisfied with the arrangement, including the advance payment, approving the lease for the hospital in Baton Rouge. But then, suddenly, two weeks ago, without the usual bureaucratic warnings, CMS disapproved the whole deal.

Its objections, on close examination, seem nearly ludicrous. CMS wrote, and has reportedly confirmed in conference calls, that it is satisfied with the idea of leasing out the hospitals and with the overall valuation of the leases — but just not with the advance payments.

Looked at practically, the only way the leases could harm the federal government would be if they somehow allowed Louisiana to attract extra federal matching funds. But the advance payments have nothing to do with this. If the total amount of the leases is not objectionable, then it shouldn’t matter if some of the payments come earlier than others, because the overall federal matching funds for the life of the leases will be the same.

Furthermore, as Louisiana officials are quick to point out, the advance payments were used not as bait for higher federal matches going forward but instead to “backfill” the budget gap in other areas caused by the feds’ tightening of the financing formula in fiscal year 2013. (For various non-political reasons, Louisiana suffered by far the largest reduction in “F-map” funds when the formula was changed.) In other words, the federal budget didn’t, and won’t, suffer from the state’s new leasing arrangement.

But now the leases are in limbo, and the state’s beneficial reforms could be in jeopardy.

All of which might be of interest only to Louisianans — if this latest slap in the face to the state weren’t so obviously part of a pattern. Combined with so much other evidence of the Obama administration’s use of bureaucratic and administrative means to punish political enemies — the IRS scandal, the sacking of honest inspectors general, the Homeland Security listing of conservative groups as potential terrorist hotbeds — this war against Louisiana takes on somewhat ominous overtones.

The message from Obamaville goes out: Cross us, and anybody in your orbit, even low-income medical patients, will suffer.

The good news for Louisiana is that the state has a good chance, on appeal, eventually to win approval of its hospital leases. For the rest of the country, this year and in 2016, the appeal for relief must come through the ballot box.

— Quin Hillyer is a contributing editor for National Review. Follow him on Twitter @QuinHillyer.


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