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Louisiana takes a healthy step forward today

It's Medicaid Expansion Day in Louisiana. That's good news for state finances, and better news for the 375,000 low-income residents who'll now be covered.
Democratic state Rep. John Bel Edwards addresses supporters at the Lyceum Dean Ballroom in Baton Rouge, La., Oct. 24, 2015, after advancing to a runoff in the Louisiana governor's race. (Photo by Ted Jackson/ /The Times-Picayune/AP)
Democratic state Rep. John Bel Edwards addresses supporters at the Lyceum Dean Ballroom in Baton Rouge, La., Oct. 24, 2015, after advancing to a runoff in the Louisiana governor's race. 
When Kentucky Gov. Matt Bevin (R), running on an anti-ACA platform, won his statewide race last fall, the conventional wisdom was unforgiving: the 2015 elections, we were told, were a step backward for proponents of health care reform. Six months later, however, the landscape looks quite a bit more encouraging for health care proponents.
In Kentucky, the far-right governor backed off his campaign pledge on Medicaid expansion, and in last year's other gubernatorial race, Louisiana's John Bel Edwards (D) embraced Medicaid expansion in a policy that takes effect today. The Times-Picayune in New Orleans reported last night:

Department of Health and Hospitals will begin the massive task Wednesday (June 1) of enrolling 375,000 people into the state's expanded Medicaid program. The department's goal is to get Medicaid insurance cards into the hands of more than half of the people eligible for the program by July 1. Ruth Kennedy, the DHH official who is leading enrollment efforts, said in an interview Tuesday that although the task of enrolling so many people into the federally funded Medicaid expansion sounds daunting, the department has taken an "all hands on deck approach." She added that state officials have prepared for months to enroll Medicaid recipients, and workers are positioned across the state to aid in the effort.

Circling back to our coverage from a couple of months ago, few states needed 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, so he took a firm stand against anything related to "Obamacare."
Edwards, however, won his statewide race -- despite being a Democrat in a red state in the Deep South -- promising to implement Medicaid expansion, which he did soon after taking office. The governor did this in part for moral reasons -- it's the right thing to do for low-income families -- but also for financial reasons. As Edwards told the legislature in the early spring, "We know we're going to save money."
And he knows this because it's true.
As we discussed at the time, 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 -- has found the arithmetic undeniable.
That's good news for Louisiana's finances, and even better news for the 375,000 low-income Louisianans who'll now be able to receive affordable medical care.