How the nursing home lobby blocked reforms in Louisiana

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In 2015, a crisis of sorts loomed for nursing home owners when Bobby Jindal, the governor, considered an overhaul of Louisiana’s policies, one that would have shifted more money to home-based providers and away from nursing homes. The reform, two years in the making, was dropped when the nursing home industry complained—an episode recounted in a recent report by the Advocate newspaper. John Bel Edwards, Mr Jindal’s successor, said during his campaign in 2015 that he wanted to pursue the plan Mr Jindal had dropped. But Mr Edwards seems to have lost his interest in it.

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This is regrettable. Surveys have shown that given the choice and some help with basic tasks, most older folks would rather stay in their own homes than be institutionalised. That option also tends to be cheaper. Most states have been going in this direction: in a typical state, about 60% of the Medicaid budget for long-term care goes to nursing homes; the other 40% goes to home- and community-based care. The ratio has been getting closer to par every year. But in Louisiana, 77% of that pie goes to nursing homes, a share that has grown in each of the last four years.

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