by Republican Gov. Jeff Landry’s administration unilaterally increased Medicaid payments by $22 million to seven hospitals, four of which are owned by a political donor of Landry who is also a friend and hunting buddy of Donald Trump Jr.
The spending decision came less than a month after the Health Ministry warned it might be necessary slash services for children and people with disabilities due to a looming budget deficit.
The hospitals are located in rural parts of the state, where medical care is difficult to find. The Landry administration said the facilities “could be forced to close” without the additional support.
The Louisiana Health Department increased hospitals’ Medicaid payments on September 16, without notice. It provided the money through an emergency rulemaking process that bypasses the public hearings and comment periods that normally accompany such decisions.
In interviews, legislative leaders said they still feel hospitals need the extra dollars.
“We are taking care of the people who rely on these hospitals,” said Senate President Cameron Henry, R-Metairie.
Trump connection
Four of the seven hospitals receiving the rate increases are owned by Republican political donor Rock Bordelon. Ochsner Health System, Franciscan Missionaries of Our Lady and Christ Health System run the other three hospitals that expect higher Medicaid payments.
Bordelon’s company, Bossier City-based Allegiance Health Management, has 11 rural hospitals in Louisiana. Eight have been purchased since early 2016, the year the state’s Medicaid expansion went into effect. Clinics, hospice centers and other health facilities are also part of its activities.
Seven Bordelon hospitals in Louisiana already qualified for higher Medicaid rates because the facilities are covered by the Rural Hospital Preservation Act. Approved in 1997, it allows 50 hospitals in less populated parts of the state to receive a much higher per-day bed rate, $2,737, for admitting a Medicaid patient needing acute care. Most hospitals in Louisiana would receive less than half that amount — between $1,037 and $1,211 per day — for treating the same person.
Now, Bordelon’s four remaining hospitals in Louisiana will also receive above-average funding. Their acute care payments increased from $1,174 to $2,327 per bed per day under emergency rules passed by the Landry administration.
Bordelon said in an email this week that the extra money is needed. Without it, hospitals would “lose millions a year” caring for Medicaid patients.
“This new provision simply allows these seven hospitals to be reimbursed at a similar, but lower rate, than the other 50 rural hospitals protected by the late 1990s law,” he wrote.
Shortly after he started buying up rural hospitals at an accelerated pace eight years ago, Bordelon turned into a significant political donor in Louisiana. He and his companies have given state politicians, gubernatorial candidates and political groups $291,000 since 2018, according to a review of campaign finance reports.
Nearly a fifth of those donations, $53,500, went to Landry and the governor’s political action committee, CAJUN PAC II. Attorney General Liz Murrill also received a large share of the contributions: $42,500 during last year’s election cycle.
Bordelon characterized his political donations as bipartisan in an email, noting that he had also given $10,000 to former Democratic Gov. John Bel Edwards.
Nevertheless, the vast majority of political donations from Bordelon and its companies have gone to Republicans. Only 4% of that money has gone to Democratic state officials since 2018.
The hospital owner also has something more valuable to offer Republican officials than money: a personal connection to the Trump family.
When he’s not working as a healthcare executive, Bordelon produces and stars in a hunting show called ‘On the road.Donald Trump Jr., an avid outdoorsman, appears on the program.
“We met many years ago through hunting and that’s how we became friends, not through politics,” Bordelon said. “He is one of many celebrity guests who hunt with me on my show.”
The relationship with Trump Jr. appears to be both personal and political for Bordelon.
In July alone, Bordelon posted photos to his personal Instagram account of him and Trump Jr. appeared together on a panel at the Republican National Convention; posing in the wilderness behind a moose that had just been shot and facing each other in the cabin of a private plane.
More recently, Bordelon, Trump Jr. and one of Trump Jr.’s children. Landry’s famous alligator hunt fundraiser took place the weekend after Labor Day, according to photos on Bordelon’s Instagram account. Trump Jr. appears in one photo with Landry and Bordelon, and in two other photos with Bordelon in an airboat during the event.
Bordelon and Trump Jr. are also members of the board of Hunter Nation, a foundation that aims to mobilize hunters in swing states to vote in this fall’s presidential elections.
According to AxiosBordelon pointed to the success of Landry’s election in Louisiana last year as evidence that Hunter Nation could make a difference for Donald Trump Sr. in the presidential race. Bordelon said the organization has had more than 60,000 Louisiana hunters, who were not politically engaged, vote in Louisiana’s 2023 gubernatorial race.
But the decision to raise Medicaid rates for four of Bordelon’s hospitals is not related to his political activities, he said. The process to increase payments was underway before Landry replaced Edwards earlier this year.
“The current leadership of the Department of Health saw this come to fruition,” he said in an email. “This is not about party affiliation, this is about my passion to improve access to care in rural Louisiana to prevent rural hospitals in La. from closing.”
Landry’s office declined to comment for this report and referred questions to the health department.
“This new funding will help ensure that the rural communities where these hospitals are located can continue to provide emergency medical services and other critical health needs,” said Kevin Litten, spokesperson for the Department of Health.
Litten added that the higher Medicaid rates were adopted on an emergency basis because there was “years of delay in addressing this issue for the rural hospitals that were not included in the Rural Hospital Preservation Act.”
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Budget problems
The increase in hospital rates that will benefit Bordelon hospitals comes at a difficult financial time for Louisiana. The state faces a $587 million budget deficit next fiscal year that could get significantly worse.
Landry’s Health Minister Michael Harrington told lawmakers his department would be forced to cut services for children, seniors and people with disabilities if he were to absorb the cuts the governor has warned could be in store.
Most of the additional $22 million going to the seven hospitals this fiscal year is federal funding. The Louisiana Health Department cannot move to other programs, but $5.2 million will come from the state’s general fund. That state money could be used next year to pay for health care services that would face cuts if desired.
“It’s all a choice they make. It’s so weird. Why are the services we provide [ that are at risk]?” said Kelly Monroe, executive director of The Arc of Louisiana, which provides services to people with intellectual and developmental disabilities.
If disability services are reduced next year, Monroe says providers like her may have to drop clients with more complex needs, such as those with physical limitations in addition to intellectual challenges.
The new daily bed rate for the seven hospitals is subject to federal government approval, which is usually easy.
“If you want to keep them open, you really have to pay that rate. These are small hospitals with high Medicaid numbers,” said Rep. Dustin Miller, D-Opelousas, chairman of the Louisiana House Health and Welfare Committee and a nurse practitioner.
