While he was running for governor of Louisiana, Democrat John Bel Edwards pledged to expand Medicaid on his first day in office under the Affordable Care Act. Earlier this month, he followed through, and told voters in his inaugural address that their tax dollars “should not be going to one of the 30 other states that have expanded Medicaid, when we are one of the states that expansion will help the most.” Now, state officials are getting to work, ramping up plans to set up the infrastructure and outreach necessary to get citizens signed up. But with a bottomless deficit to contend with and cultural shifts in the health-care field still necessary, they’ve got their hands full.
Louisiana’s new Department of Health and Hospitals secretary, Rebekah Gee, calls her home “an island in a sea of Southern states,” whose only neighbor with Medicaid expansion is Arkansas. (There, like in Kentucky, the governor is seeking approval from the federal government to make changes to the state’s program.) Before Edwards’s executive order, roughly 1.4 million Louisianans were covered through Medicaid, and the state anticipates an additional 300,000 will be enrolled come July 1 under the expansion. There are two other “populations” that could register as well, the state’s interim Medicaid director, Jen Steele, notes: Those who already have insurance but fall within the qualifying income and age range under Medicaid expansion—they could choose to switch—and the so-called woodwork population, who have long been qualified to receive funds but haven’t yet signed up.