Louisiana: 47% of those eligible for Medicaid expansion already enrolled...in first 11 HOURS.

A few weeks ago I noted that thanks to the election of Democratic Governor John Bel Edwards (with an assist by David Vitter's diaper fetish), up to 375,000 lower-income Louisiana residents became eligible for the ACA's Medicaid expansion provision starting a month earlier than expected (June 1st instead of July 1st).

Enrollment officially started early this morning (not sure if it was right at midnight or if they had to wait until the state offices opened or whatever), and as of around 11:40am...

Gov. Edwards announces that there are already 175,000 Louisianans enrolled in the expanded Medicaid program. #lagov #lalege

— Gov John Bel Edwards (@LouisianaGov) June 1, 2016

Holy Smokes.

Of course, as Andrew Sprung and I noted last summer, the irony here is that since private exchange policies provide tax credits for enrollees starting at 100% FPL and up, and Medicaid expansion covers those up to 138% FPL, there's a significant overlap between the expansion population and Louisiana's 214,000 exchange QHP enrollees. About 48% of these (around 103K) are between 100-150% FPL; assuming an even income distribution across that range (which may or may not be accurate), that's roughly 78,000 people in the 100-138% FPL range.

However, due to standard attrition, the 214K figure has likely already dropped off by at least 12% or so to perhaps 188K, so perhaps 68,000 Louisianans are now in the process of being shifted over from heavily subsidized exchange QHPs over to Medicaid itself.

This means that when the 2nd quarterly Effectuated Enrollment Report is released (which probably won't happen until September), it's very likely to show Louisiana having "lost" a good 45% of their exchange enrollees...but in fact most of that "loss" will simply be people moving over to Medicaid. Keep that in mind in a few months.

OK, so that's around 68K of the 375K eligible. Most of the remaining 307K or so are presumably currently uninsured at all, which means that if LA maxes out their eligible enrollees soon (and that sounds likely given the massive Day One signups), this development could singlehandedly lower the national uninsured rate by nearly a tenth of a percentage point:

  • 307,000 x 90% currently uninsured (?) = 276,000
  • Total U.S. Population = Around 322 million
  • 276K / 322M = 0.086%