LSU System President William Jenkins said Thursday decisions haven't been made about how to strip $329 million from the university's hospital system, and he offered no assurances to lawmakers that hospitals and clinics wouldn't be faced with closure.
State House members questioned why Gov. Bobby Jindal's administration levied the cuts so heavily on the safety net hospital system that cares for the poor and uninsured and that trains many of the state's medical students.
Several lawmakers suggested Jindal administration leaders weren't straightforward about the implications of the budget slashing. And they worried the deep reductions would damage services and leave people without care.
"People are just living in fear right now," said Rep. Scott Simon, R-Abita Springs, chairman of the House Health and Welfare Committee.
Lawmakers on the House budget and health care committees were seeking details about $523 million in health care cuts announced by Jindal's administration last week — two-thirds of which will fall on the LSU health care system. The reductions for the 2012-13 budget year are tied to a congressional decision to drop Louisiana's Medicaid funding rate.
"Within six days, it's very difficult for us to come up with a finite and complete plan to deal with the challenges before us," Jenkins said. He added, "Within a month, we have to have at least the inklings of how we're going to handle it. We don't have a lot of time."
The LSU president noted that hospitals couldn't be closed without legislative approval, and he said university leaders will have continuing conversations with lawmakers about the cuts, never saying facility closures won't be needed.
And the cuts could grow worse for the 10-hospital system in the budget year that began July 1.
Health and Hospitals Secretary Bruce Greenstein said if state income estimates don't improve to fill the remaining gap in Louisiana's Medicaid budget, any additional cuts would "fall primarily on the LSU hospitals."
The announced reductions strip 25 percent of the public health care system's nearly $1.3 billion budget. Greenstein said the LSU hospitals will need to change their model of providing care and modernize to cope with the funding loss, but he offered few details of what changes should be made.
"All we're doing is starving the LSU system to force change, and people are going to be impacted," said Rep. Patricia Smith, D-Baton Rouge.
LSU board member Bobby Yarborough, a Jindal ally, said he was confident a "new and improved model" will emerge from the budget cuts, and he said university leaders were combing the country for ideas. He said it was premature to describe how the cuts will be divvied up.
As lawmakers bristled at the lack of details, Yarborough asked for patience and more time.
Page 2 of 2 - "Let's don't do a disservice to our citizens by rushing the cake before it's baked," he said.
Republicans and Democrats questioned why LSU's health care systems chief, Fred Cerise, wasn't at the hearing to discuss the impact of the steep reductions.
Cerise is a doctor, health care secretary for former Gov. Kathleen Blanco and longtime supporter of the charity hospital system who has been noticeably quiet since the cuts were announced. Before the cuts were announced, he had said the facilities had little wiggle room to make reductions and suggested smaller amounts of budget slashing could force hospital closures.
Yarborough said Cerise wouldn't be making the decision about how the cuts are made, but could be available to talk to lawmakers at their next hearing.
"He's not speaking with any decision-making authority. That will be the board and the president of the LSU System," Yarborough said.
Other cuts will shutter a state-run psychiatric hospital in Mandeville, lay off more than 300 people and strip uninsured funding to small, rural hospitals.
The reductions were made by the administration, with no decision-making from lawmakers.
Democrats criticized Jindal as being largely absent from the conversation about the cuts while he's been campaigning for Mitt Romney's presidential bid. They said he should have personally reached out to congressional leadership to try to stop the reductions from happening.
"Our governor can go all over the country right now campaigning for the Republican national party, but this administration is not comfortable asking for more money from those same leaders?" said Rep. Katrina Jackson, D-Monroe.
Several conservative House Republicans who unsuccessfully pushed for budget cuts during the legislative session questioned what they described as Greenstein's change in tone.
They said the health secretary described smaller cuts as devastating when the Jindal administration was fighting the reductions in the Legislature, but Greenstein said Thursday that the larger cuts forced by Congress were "a difficult time, but this is not a crisis."
"I get the politics of it, but please don't sit there and try to convince me that these are different scenarios. ... The first scenario was painless compared to what we're talking about now," said Rep. John Schroder, R-Covington,
The hearing drew half the members of the Louisiana House. A joint meeting of the House and Senate budget committees on Monday also will discuss the health care cuts.