Three years after expanding access to the state's Medicaid program, Louisiana Gov. John Bel Edwards touted a new study showing the program's benefits for Louisiana patients and providers.
His comments at St. Bernard Parish Hospital Wednesday came as a lawsuit challenges the expansion’s existence while Louisiana Republicans question its cost.
“More than 450,000 working poor in Louisiana have access to health care that didn’t have it before,” Edwards said.
Fewer people are putting off going to the doctor or rationing their medicine because they can’t afford to pay, the study says. More people are getting care in a timely fashion, according to the study, and fewer people are using emergency departments as their primary care provider.
The Medicaid expansion is part of the federal Affordable Care Act, which currently is being challenged in the courts. Louisiana Attorney General Jeff Landry, who is one of the state attorneys general supporting the lawsuit, told lawmakers during the most recent legislative session that he expects the federal government to keep funding the expansion even if the ACA is thrown out, though U.S. Sen. John Kennedy said he was unsure if that would happen.
No rural hospitals have closed in Louisiana, in contrast to other states that have not expanded Medicaid, Edwards said, adding that when hospitals close, everyone loses access to that facility, not just the poor and uninsured.
“Rural hospitals don’t just provide care,” he said. “They are an economic driver for the community.”
Edwards said expansion has saved the state’s general fund some $300 million, while ensuring Louisiana taxpayers get full value for the dollars they send to Washington that help fund Medicaid expansion whether or not Louisiana takes advantage. The Edwards administration says a recently implemented electronic system helps ensure ineligible people aren’t receiving Medicaid benefits, though Republicans are wary of that claim, saying the administration resists legislative scrutiny of the program.
Rep. Tony Bacala, R-Prairieville, said Monday that dating back to the end of former Gov. Bobby Jindal’s administration, the state’s total budget was $27.15 billion including federal dollars, of which $9.3 billion was Medicaid-related. Today, the state spends more than $34 billion, he said, and he attributed about 64 percent of that growth to the Medicaid program.
Set aside spending by the Department of Health, which is mostly for Medicaid, and state spending only grew about 2 percent per year, which is “not great, but it’s not horrible,” Bacala said.
The Tulane University study released Wednesday focused on the expansion population, which includes people making up to 138 percent of the federal poverty level. Among other findings, it says:
- The number of people who report they were unable to see a doctor in the past year due to cost dropped by 26 percent.
- The number of people who report they did not take medication as prescribed due to cost dropped by 66.4 percent.
- The number of people who report they were unable to get care soon enough decreased by 58 percent.
- The number of people who report they had one person they think of as their personal doctor rose by 4.2 percent.
- The number of providers who filed at least 10 Medicaid claims per month increased from 9,730 to 11,035. However, participation by specialists has fallen, after peaking shortly after the 2016 expansion.
- Emergency department visits per 1,000 Medicaid expansion enrollees decreased from 115 visits per month to 90 visits per month between 2016 and 2018.
Data used in the report was obtained from the Louisiana Medicaid Data Warehouse claims database, including program enrollment numbers, chronic condition status, health care use, and provider participation.
Edwards issued an executive order accepting the federal government's Medicaid expansion on his first full day in office in 2016. The expansion went into effect in July of that year.
Jindal had declined to participate in the expansion, saying it was unwise to expand a program already on a financially unsustainable path, though critics say his national political ambitions influenced his decision.