Louisiana’s Medicaid expansion reaches 500K, still growing

February 8, 2019 GMT

BATON ROUGE, La. (AP) — Louisiana’s Medicaid expansion program continues to add more people to the taxpayer-financed health insurance rolls, topping 500,000 enrollees this year and growing at a pace unexpected by Gov. John Bel Edwards’ administration.

The Louisiana Department of Health expected a steeper slowdown in enrollment nearly three years after the Democratic governor expanded Medicaid to cover more nonelderly adults, as allowed under the federal health overhaul.


Instead, agency financial officer Pam Diez said the department’s continuing to see sizable numbers of new sign-ups for the program, estimating a 7.5 percent enrollment increase this budget year, followed by a similar increase next year.

The health department is trying to determine what’s driving the ongoing increases.

“We just thought that expansion would be at a much slower growth than this right now,” Diez told a Medicaid forecasting panel. “Early data is showing that the bulk of the increases are coming from the New Orleans area. We’re trying to drill down on that.”

Medicaid expansion is expected to provide insurance to 560,000 people by June 2020, according to health department enrollment estimates provided Thursday to The Associated Press. Diez said at that point, about 89 percent of Louisiana residents eligible for Medicaid expansion would be enrolled in the program.

“We’re hoping that will level out,” she said.

A new computer upgrade aimed at double-checking more Medicaid recipients’ income to ensure they are eligible for coverage could curb some of the expected growth, Diez told the forecasting panel.

Medicaid expansion began July 1, 2016, with Louisiana becoming the first Deep South state to participate. More than 440,000 working poor and nonelderly adults signed up for the government-financed coverage within the first budget year. Enrollment grew past 500,000 in January.

Edwards, running for a second term in office, has credited the expansion with cutting Louisiana’s uninsured rate in half, to 8.4 percent in the latest Census numbers, lower than the national average. He notes that thousands of people newly added to the Medicaid rolls have received preventive services that have identified cancer, diabetes and other illnesses.

Adults ages 19 to 64 with incomes up to 138 percent of the federal poverty level — about $16,750 for a single adult or $28,680 for a family of three — are eligible for the coverage through one of Louisiana’s Medicaid plans administered by private managed-care companies.


Republicans say the expansion is too costly and has grown the Medicaid program at an unsustainable rate. Louisiana is expected to have 1.7 million people, 37 percent of the state’s population, enrolled in Medicaid through the expansion and non-expansion programs by June.

The federal government is paying most of the Medicaid expansion cost. Louisiana is paying a share that eventually increases to 10 percent. Lawmakers passed financing tools to help cover the state’s costs, including a tax hike charged on health maintenance organizations.

GOP lawmakers point to legislative audits that show misspending, including one released in November that said the Medicaid expansion may have spent as much as $85M on ineligible enrollees. The Edwards administration said the computer upgrade will address those concerns, doing more frequent income reviews for eligibility and using more data for comparison, exceeding federal requirements.


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