BEYOND THE NUMBERS
Health coverage takes effect tomorrow for people enrolling in Louisiana’s Medicaid expansion. Based on state projections and the experience of other expansion states, here is what we can expect:
- Dramatic gains in health coverage. The nation has made historic progress in reducing the number of uninsured since health reform’s major coverage provisions took effect in 2014, especially in states that have expanded Medicaid. The largest gains have come in Arkansas and Kentucky, whose uninsured rates among adults have plummeted from 22.5 percent to 9.6 percent and from 20.4 percent to 7.5 percent, respectively. Like Louisiana, these are southern states that provided very limited Medicaid coverage for adults before health reform.
Louisiana has taken a head start, with more than 225,000 people already enrolled in its Medicaid expansion. The state has moved people who’d been receiving limited Medicaid coverage under federal waivers into expansion’s more comprehensive coverage. And it’s implemented a strategy to fast-track enrollment of uninsured SNAP (food stamps) recipients into expansion coverage.
- State savings for years to come. Louisiana expects the expansion to save it $677 million over the next five years. That’s because the state will spend less on payments to hospitals for serving the uninsured and collect more tax revenue from Medicaid managed care plans due to rising enrollment. Louisiana is one of a number of expansion states that expect continued savings, even as states begin paying a modest portion of the cost of covering the newly eligible starting next year, as our recent report shows.
- Targeted care for vulnerable populations. The Medicaid expansion gives states an opportunity to deliver care to people with complex health conditions that make it hard to get or keep jobs or steer clear of the criminal justice system. Louisiana officials say they’re looking for ways to connect people leaving jail or prison with expansion coverage and needed mental health treatment in order to reduce recidivism.