More than 300,000 people are being added to Louisiana’s Medicaid rolls after Gov. John Bel Edwards (D) expanded the program by executive order on his first day as Louisiana’s newly elected governor.
Edwards’ January 12 order opens the state’s Medicaid rolls to 298,000 newly eligible, non-elderly adults whose income falls below 138 percent of the poverty level, according to an analysis from the state’s Legislative Fiscal Office (LFO). LFO says 224,000 people who currently have private or employer-sponsored health insurance will also become eligible to switch to Medicaid, and LFO predicts up to 89,600 of these people will drop their private plans and join Medicaid.
Expanding Dependence on Government
Kevin Kane, president of the Pelican Institute for Public Policy, says Edwards’ order will increase costs and dependence on government.
“Given the poor outcomes for people on Medicaid, one would expect the quality of care to decline when people move from private insurance to Medicaid,” Kane said. “In either event, how can anyone argue that we should strive to maximize the number of people who rely on government to provide a basic service like health care?”
Shifting the poorest Americans to the government rolls was “part of a deal” insurance companies originally struck when many agreed to support the Affordable Care Act, says Josh Brown, a legislative advocate and policy analyst for the Ohio Municipal League.
“The insurance companies would agree to Obamacare’s regulations if the federal government would take the most costly customers out of the market by getting them on Medicaid,” Brown said. “Meanwhile, government dependence is increased.”
Expansion Shifts Taxpayer Burden
Edwards says his order to expand Medicaid “would ensure that Louisiana has the full financial support of the federal government” and allow state leaders to “focus our attention on getting our finances in order,” according to a press release by his office at the time of the signing.
Kane says Edwards’ order increases the burden placed on the state’s taxpayers.
“The taxpayers are ultimately on the hook for these federal programs, so we should not pretend that this is ‘free’ money,” Kane said. “If the federal government reduces its share of the Medicaid burden, the states will have to pick up the slack.”
Instead of expanding Medicaid, states should be given more flexibility in determining how to handle uninsured citizens, Kane says.
“Unfortunately, states cannot take this power for themselves,” Kane said. “It will need to be granted by policymakers in [Washington,] DC. This is unlikely to happen unless states push back against Medicaid expansion and lobby for a new approach.”
Ben Johnson ([email protected]) writes from Stockport, Ohio.
James A. Richardson, Jared J. Llorens, and Roy Heidelberg, Medicaid Expansion, Budgetary Projections, and Impact on Hospitals, Louisiana Public Health Institute, January 2016: