Louisiana's Governor-elect Makes Plans for Medicaid Expansion

John Bel Edwards was elected Governor of Louisiana Saturday after promising to expand Medicaid. Hospitals have been eager to see expansion; in the spring, they supported a fee to pay the state's share once the federal government stops paying 100% of expansion costs.

The day after he became the first Democrat to win a governor’s race in the South in 12 years, Louisiana’s John Bel Edwards said that Medicaid expansion would be “among the highest priorities” once he was sworn in, although he would make sure the financing works for the long haul.

Edwards told the New Orleans Times-Picayune that there is a “difference of opinion” whether a financing measure that sailed through the Legislature this spring will provide enough money to cover Louisiana’s share once the federal government stopped paying 100% of the cost of expansion after 2017.

The states’ hospitals have been eager for expansion and agreed to pay fees that would help pay that share. The plan also features a base reimbursement level for Medicaid, including payments for the uninsured.

However, on November 11, 2015, just 10 days before the election, the Legislative Fiscal Office backed off its projections that the measure would cover all the costs. The Advocate’s Baton Rouge bureau quoted an analyst who said the fees would cover reimbursements for hospital services for those newly eligible, but not all expansion costs.

Throughout the campaign, Edwards did not shy away from his support for Medicaid expansion, and many view his appointment of a like-minded state senator as his chief of staff as the best sign that it will happen quickly.

The lawmaker, state Senator Ben Nevers, said, “There are over 242,000 people without medical insurance in this state who go to work every day, who have been dependable employees. It would mean the opportunity for them to have insurance for them and their families.

“I can tell you that there’s many people across this state who’ve suffered tremendously because we’ve refused to expand Medicaid,” Nevers said.

Louisiana ranks poorly on several health indicators, according to the Trust for America’s Health. The state ranks fourth in the nation for hypertension, sixth for diabetes at 11.6% of the population, sixth for obesity (and fourth for childhood obesity), fourth for syphilis, and second for low-birth weight babies.