The Bush administration wants the state to use much of the federal funding that has always helped support public hospitals to subsidize private health insurance for people who lack coverage. Such a strategy would build on proposals President Bush outlined in his State of the Union address this year.
"It is time to level the playing field," Medicare and Medicaid Administrator Leslie V. Norwalk told the committee. The poor and uninsured should have the same kind of coverage as people with private insurance, she said.
But Louisiana officials said there was not enough money going to public hospitals to subsidize insurance for all those in need -- only for about half of them.
"It's not a simple move," Louisiana Secretary of Health and Hospitals Dr. Fred Cerise told the panel. "Those funds are buying services today."
Cerise estimated it would take an additional $1 billion each year to make sure the vast majority of the population was insured.
Committee members of both parties urged state and federal officials to back away from the philosophical standoff and look for practical ways to work together.
"I fear that the state and federal governments will become locked into a colossal fight of dueling spreadsheets," said Rep. Bart Stupak (D-Mich.), chairman of the subcommittee on oversight and investigations that held the hearing.
"Perhaps rather than a one-size-fits-all plan ... the state and the federal government should attempt to address smaller portions of this problem," Stupak said.
"It sounds like we need to focus more about meeting needs today and talk about the future later," said Rep. Edward Whitfield of Kentucky, the panel's ranking Republican.
State and federal officials pledged to keep talking, but it was unclear how the impasse would be resolved.
In the meantime, doctors warned, patients would keep falling through the cracks.
ricardo.alonso-zaldivar@latimes.com
