Gov. Jeff Landry’s administration has raised Medicaid rates for rural hospitals owned by one of his political donors, even as budget cuts loom. (Getty Images)
Republican Gov. Jeff Landry’s administration unilaterally increased Medicaid payments by $22 million to seven hospitals, four of which are owned by a Landry political donor who is also a friend and hunting buddy of Donald Trump Jr.
The spending decision came less than a month after the state health department warned it might have to slash services for children and people with disabilities because of a looming budget deficit.
The hospitals are in rural parts of the state where it is difficult to find medical care. The Landry administration said the facilities could be “forced to close” without the extra support.
Louisiana’s health department increased the hospitals’ Medicaid payments on Sept. 16 with no advance notice. It provided the money through an emergency rule process that circumvents the public hearings and comment periods that normally accompany such decisions.
In interviews, legislative leaders said they still feel the hospitals need the extra dollars.
“We’re taking care of the people that rely on those hospitals,” Senate President Cameron Henry, R-Metairie, said.
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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 Christus Health System run the other three hospitals slated for higher Medicaid payments.
Bordelon’s company, Allegiance Health Management of Bossier City, has 11 rural hospitals across Louisiana. Eight have been purchased since the beginning of 2016, the year Medicaid expansion took effect in the state. Clinics, hospice centers and other health facilities are also part of his business.
Seven Bordelon hospitals in Louisiana already qualified for higher Medicaid rates because the facilities are covered under the state Rural Hospital Preservation Act. Approved in 1997, it allows 50 hospitals in less populated parts of the state to receive a far higher daily bed rate, $2,737, for taking a Medicaid patient needing acute care. Most hospitals in Louisiana would get less than half of that amount — between $1037 and $1,211 per day — for treating the same person.
Now Bordelon’s four remaining Louisiana hospitals will also receive above-average funding. Their acut care payments have gone from $1,174 to $2,327 per bed per day under the emergency rules the Landry administration adopted.
In an email this week, Bordelon said the additional money is needed. Without it, the hospitals would “lose millions per year” taking care of Medicaid patients.
“This new provision simply allows these 7 hospitals to be reimbursed at a similar, but lower rate, than the other 50 rural hospitals protected by the act from the late 1990’s,” he wrote.
Shortly after he started buying rural hospitals at a faster clip eight years ago, Bordelon turned into a sizable Louisiana political donor. 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.
Almost 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 in last year’s election cycle.
Bordelon characterized his political giving as bipartisan in an email, pointing out he had also given $10,000 to former Democratic Gov. John Bel Edwards.
Nevertheless, the overwhelming majority of political donations from Bordelon and his companies have gone to Republicans. Just 4% of that money has ended up with state Democratic officials since 2018.
The hospital owner also has something more treasured to offer Republican officials than money — a personal link to the Trump family.
When he isn’t working as a health care 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 that 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 he and Trump Jr. appearing together on a panel during the Republican National Convention; posing in the wilderness behind an elk that had just been shot and sitting across from each other in the cabin of a private plane.
More recently, Bordelon, Trump Jr. and one of Trump Jr.’s children attended Landry’s famous alligator hunt fundraiser the weekend after Labor Day, according to photos on Bordelon’s Instagram account. Trump Jr. appears in a photo with Landry and Bordelon, and in two other pictures with Bordelon in an airboat at the event.
Bordelon and Trump Jr. also serve on the board of Hunter Nation, a foundation aimed at mobilizing hunters in swing states to vote in the presidential election this fall.
According to Axios, Bordelon 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 turned out more than 60,000 Louisiana hunters who weren’t politically engaged to vote in Louisiana’s 2023 gubernatorial race.
But the decision to raise Medicaid rates for four of Bordelon’s hospitals is not connected to any of his political activity, he said. The process to increase the payments had gotten underway before Landry replaced Edwards at the beginning of the year.
“(T)he current Department of Health leadership saw it to fruition,” he said in an email. “This isn’t about party affiliation, this is about my passion to improve access to care in rural Louisiana, to help keep rural hospitals from closing in La.”
Landry’s office declined to comment for this report, referring questions to the health department instead.
“This new funding helps ensure the rural communities where these hospitals are located can continue providing emergency medical services and other critical health needs,” health department spokesman Kevin Litten said.
Litten added the higher Medicaid rates were adopted on an emergency basis because there was a “years-long delay in addressing this issue for the rural hospitals that were not included in the Rural Hospital Preservation Act.”
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Budget woes
The hospital rate increase that helps Bordelon’s hospitals comes at a difficult financial time for Louisiana. The state is facing a $587 million budget deficit next fiscal year that could grow significantly worse.
Landry’s Health Secretary Michael Harrington told lawmakers his department would be forced to cut services for children, seniors and people with disabilities if he had to absorb the funding reduction the governor has warned could be in store.
Most of the extra $22 million going to the seven hospitals this fiscal year is federal funding the Louisiana health department can’t move to its other programs, but $5.2 million comes from the state general fund. That state money could be used next year to pay health care services that are facing cuts if desired.
“It’s all a choice that they are making. It’s so weird. Why is it the services that 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 said providers like her may have to drop clients with more complex needs, such as those who have physical limitations on top of intellectual challenges.
The new daily bed rate for the seven hospitals is contingent on approval from the federal government, which typically comes easily.
“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.