The Times Picayune - Louisiana Gets Innovative to Catch Up on Medicaid Expansion
Op-Ed
By John Edwards
Louisiana is behind on expanding Medicaid because the state refused to accept the extra federal money until Gov. John Bel Edwards took office in January. But an innovative approach by the Department of Health and Hospitals could allow tens of thousands of eligible residents to be approved almost immediately.
That could make a huge difference for those families and would jumpstart the state's effort to sign up an estimated 375,000 Louisianians expected to qualify for Medicaid under the expansion.
Food stamp data will be used for Medicaid expansion
Food stamp data will be used for Medicaid expansion
The data will be used to auto-enroll tens of thousands of people who don't make enough money to afford health insurance.
DHH officials are "highly confident" that federal Medicaid officials will approve their request to use food stamp records to add uninsured residents to the health care program for low-income residents. A half-dozen other states have been allowed to fast track their enrollment process, but Louisiana would be the first one to use food stamps.
That would not only save time for families, but it would save money for the state as it implements the expansion. "We don't have to make an eligibility decision" for food stamp recipients, said Ruth Kennedy, who is overseeing the state's Medicaid expansion. That judgment has already been made by the Supplemental Nutrition Assistance Program, which issues food stamps.
Ms. Kennedy, who formerly served as DHH's Medicaid director, said the agency is getting ready to send out 100,000 letters to uninsured Louisiana residents who are eligible for coverage based on the food stamp rolls. All they need to do is answer a few questions about their household and send the information back to DHH. They can email, phone or fax to get enrolled. Coverage begins July 1.
DHH also is enrolling people who participate in the Greater New Orleans Community Health Connection and the Take Charge program. The Medicaid expansion will give those patients more benefits, including access to prescription medications.
For other enrollees, Ms. Kennedy is hoping to deploy 90 eligibility workers to 60 locations across the state to sign people up. The Legislature should make sure money is in the budget to cover those costs.
It is refreshing to see Gov. Edwards' administration come up with creative ways to get the expansion in place quickly.
"I think it makes a huge difference, and it makes a lot of sense," said Adam Searing, a senior research fellow at Georgetown University's Center for Children and Families. "What the experience has shown us so far is that people are very motivated to sign up because it's such an expense and a benefit to be able to go to the doctor. But there's not one day when everyone signs up. It typically takes a few years" to get everyone enrolled.
Under the expansion, families can make up to 138 percent of the poverty level. The state expects that change to bring in 375,000 low-income Louisiana residents who had earned too much to qualify for Medicaid coverage before. Processing all those people is a huge undertaking.
DHH Secretary Rebekah Gee was smart to put Ms. Kennedy in charge. She led the state's successful implementation in the 1990s of LaCHIP, the Medicaid-funded children's health program.
The LaCHIP process was streamlined to get thousands more children enrolled. Children who were eligible for the Supplemental Nutrition Assistance Program were automatically enrolled in Medicaid, which has the same eligibility requirements.
Louisiana's push to get more low-income children covered by health insurance paid off. In 2003, a DHH survey found that 11.1 percent of Louisiana children were uninsured. By 2011, that number was down to 3.5 percent.
Having health coverage makes it easier for a family to get preventive care. That helps keep people healthier, which is good for them and for the state as a whole.
Thankfully, the Edwards administration understands that.
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