Support/OppositionOver the years, Louisiana’s steady progress can be attributed to a number of factors.
Consistent high-level political backing. Leadership in the Department of Health and Hospitals—by Secretaries David Hood (1998-2003) and Dr. Fred Cerise (2003-2007), and LaCHIP director Ruth Kennedy—combined with strong bipartisan gubernatorial support—first by Republican Mike Foster (1996-2004) and then Democrat Kathleen Babineaux Blanco (2004-2008)—to help garner continued support.
A strong and wide base of support. Champions of these efforts in Louisiana have included, among others, a range of state children’s advocacy groups, the Robert Wood Johnson Foundation’s Covering Kids & Families coalition, many individual state legislators, and the Louisiana State Superintendent of Education (1996-2007), the late Cecil Picard, who strongly believed in the link between health and educational outcomes.
A range of effective arguments. State officials and advocates made the case for improving coverage—and the specific strategies for getting there—in a number of different ways, including: establishing the link between health and educational outcomes and between health and poverty; underscoring that investment in primary and preventive care would result in a healthier population and reduced health care costs for the state when children reached adulthood; and reminding the public that covering children is inexpensive when compared with costs for other population groups.
In 1998, there was considerable debate in the Louisiana Legislature about LaCHIP, leaving many to wonder whether the state would even implement this optional program. While legislation authorizing the creation of LaCHIP was eventually enacted, some representatives in the Louisiana Legislature opposed it, principally based on concerns about big government, crowd-out of private insurance, and sustainability in the absence of on-going federal support.
However, given the program’s success, there has been no subsequent political opposition to eligibility expansions and program changes.