BATON ROUGE — A group of businessmen and executives — including many supporters of Gov. Bobby Jindal — are calling on the next governor to expand Medicaid, raise the gasoline tax and tweak TOPS, Louisiana’s popular tuition-paying program.

Blueprint Louisiana, one of several groups suggesting policies for the winner of the gubernatorial elections, released its proposals Monday, the Advocate reports.

“We wanted to be honest and be real,” said Dr. Phillip Rozeman, president of Cardiovascular Consultants in Shreveport and chairman of Blueprint Louisiana, adding that the state needs to correct a defective budget structure that has led to repeated deficits. “We have to work at both ends — revenues and expenditures. To ignore either one won’t get us a structural fix.”
In addition to expanding Medicaid, a key element in President Barack Obama’s signature health care plan, the group wants the next governor to raise the gasoline tax in order to provide more funding for highways and eliminate the requirement that TOPS cover the full cost of tuition.

Blueprint applauded the state’s efforts to hire private insurance companies to handle work once done by government in Medicaid, the state-federal program that pays for health care for the poor — about 1.4 million people, or a quarter of the state’s population. The group also said the move toward private management of LSU charity hospitals was a breakthrough in providing greater access to quality health care.

But Blueprint also wants the state’s next leaders to expand Medicaid eligibility requirements to pick up another 300,000 Louisiana working residents who make too much money to qualify but too little to buy their own insurance on the private market.
Jindal has strongly opposed Medicaid expansion, saying it would burden state taxpayers with increased costs. Republican legislators have blocked repeated efforts to do so. The Legislature, however, passed a resolution in June, which did not need Jindal’s signature, outlining a procedure that could allow the expansion in April, after a new governor and Legislature take office.

“The truth of the matter is that we don’t necessarily agree with the Affordable Care Act,” Rozeman said.

“We have to be realistic and look at what’s best for the state,” he said, adding that the state general fund could see a savings of up to $165 million across the first five years.

Blueprint suggested that any expansion be designed to support new payment and delivery system models that focus on making it easier for patients to get health care and better outcomes from the care they receive.

“Combined with a customized approach, it seems clear-cut to us that the state should step up and accept the federal health care dollars that are rightfully Louisiana’s, which not only helps patients and providers but also provides some relief to the budget,” said Blueprint Louisiana Secretary Clay Allen, managing partner at the Lafayette law firm of Allen & Gooch.

Blueprint noted that Louisiana has cut general state support for higher education more than any other state over the past seven years. The pressure to train a workforce for new businesses in the state has prompted leaders to consider lowering admission standards in order to bring in more paying customers.

Blueprint opposes those efforts and suggests instead eliminating the requirement that TOPS automatically cover the full cost of university tuition. The group also suggests creating a more equitable benefit for community and technical college students. At the same time, university officials should be given the authority to more easily control expenses and more autonomy to set tuition and fees.

On transportation issues, Blueprint said the state relies almost exclusively on a tax of 20 cents per gallon of gasoline that has not been updated since 1990 and doesn’t generate enough money to pay for needs. Among Blueprint’s suggestions is to raise the current state tax or replace it with a better model.
Meanwhile, the administration should stop raiding the Transportation Trust Fund, which is supposed to be for transportation projects, and increase annual investment in the fund by $1 billion. Blueprint backs dedicated vehicle sales tax dollars, and perhaps increased registration fees to the trust fund.

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