Medicaid expansion is estimated to save Louisiana $677 million over the next five years and more than $1 billion over the next decade, Department of Health and Hospitals officials told Senate Health and Welfare Committee members Monday (April 18). The cost estimates came after Gov. John Bel Edwards testified before the committee about his decision to expand Medicaid eligibility to about 375,000 people between July 1 and June 30, 2017. DHH officials will make an effort in the coming weeks to educate legislators about the benefits of Medicaid expansion and what they said was misinformation given to the Legislature to justify not expanding Medicaid under former Gov. Bobby Jindal.
Few states need Medicaid expansion more than Louisiana, which made it all the more difficult to justify former Gov. Bobby Jindal's (R) refusal to consider the policy. By all appearances, the Republican made a plainly political decision without regard for the state's needs: Jindal wanted to be president (yes, of the United States), so he took a firm stand against "Obamacare."
Louisiana's current governor, Democrat John Bel Edwards, ran on a platform of Medicaid expansion through the Affordable Care Act, won his election fairly easily, and immediately adopted the policy. The Times-Picayune in New Orleans reported yesterday that the governor went directly to the legislature to explain why this was the smart move for Louisiana.
"I believe the folks in the prior administration who said we couldn't afford Medicaid expansion, they took the worst case scenario on every variable," Edwards told lawmakers in the GOP-led legislature. "If you look at what we're doing in light of experience in other states ... we know we're going to save money."
And he knows this because it's true.
I can appreciate why this may seem a little counter-intuitive. Ordinarily, when state policymakers recommend expanding benefits to struggling families, critics will respond, "We'd like to help, but we can't afford it and we're not willing to raise taxes."
But Medicaid expansion is one of those policies in which states get to do both: participating states receive federal funds to implement the program, while expanding coverage for low-income families who would otherwise go uninsured. At the same time, hospitals' finances are strengthened as medical facilities see fewer patients who can't pay their bills.
Since implementation of the Affordable Care Act began, how many states have found Medicaid expansion hurt state budgets? None. Republicans will be quick to argue that someday, maybe, in the future, the fiscal challenges will become more acute, but given pre-ACA reimbursement rates, there's no reason to believe they're correct.
It's exactly why every governor with access to a calculator -- including plenty of red-state Republicans -- have found the arithmetic undeniable.
As for Louisiana in particular, as we talked about last week, the state really is having an "elections have consequences" moment right now. Gov. Edwards, the region's only Democratic governor, hasn't been in office long, but he's already making strides to clean up the Republican mess he inherited.