Patients burst into tears at this city’s glistening new charity hospital when they learned they could get Medicaid health insurance.
In Baton Rouge, state officials had to bring in extra workers to process the flood of applications for coverage.
And at the call center for one of Louisiana’s private Medicaid plans, operators recorded their busiest day on record.
The outpouring began in June, when Louisiana became the 31st state to offer expanded Medicaid coverage through the Affordable Care Act, effectively guaranteeing health insurance to its residents for the first time.
Now, as Republican presidential nominee Donald Trump promises to repeal the healthcare law, Louisiana is emerging as a powerful illustration of the huge pent-up demand for health insurance, particularly in red states where elected officials have fought the 2010 law.
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1. Virtually all of those enrolled as of yesterday, a total of 189,000 by day's end, were transfers from existing limited-benefit public plans. These include 132,000 enrollees in Take Charge Plus, a program focused mainly on family planning, along with a few free office visits; and 56,000 from the Greater New Orleans Health Connection (GNOHC), a no-cost primary care program for low income people in the greater New Orleans area. GNOHC does not provide drug or hospital coverage.
...which is perfectly fine as well; it still lifts a huge financial burden off of the state while streamlining and consolidating enrollees into the larger Medicaid program itself.
On Wednesday I noted that a whopping 175,000 Louisianans had somehow managed to enroll in the state's just-launched Medicaid expansion program within less than 12 hours of the floodgates being opened up. This was even more amazing when you consider that number represents 47% of the total people estimated to be eligible for the program state-wide (375K).
Now, obviously there's no way that 16,000 people per hour were individually visiting HealthCare.Gov or their local state health agency; on it's busiest day (December 15, 2015), HealthCare.Gov was averaging 25K/hour...but that was across 38 states, many of which are much larger than Louisiana. Instead, I assumed that LA had done something similar to Oregon/West Virginia's "fast-track" programs, where they use existing food stamp/welfare databases to automatically enroll people, not "officially" pulling the trigger until after the stroke of midnight.
This year, about 214,000 people selected QHPs via HealthCare.Gov in Louisiana, though this has likely dropped to around 182K by now. The state's total individual market (on+off exchange, as well as grandfathered/transitional policies) was around 225,000 in 2014, and has likely increased roughly 25% since then to perhaps 280,000 total, of which around 10% is likely comprised of grandfathered/transitional enrollees. That should leave roughly 250,000 ACA-compliant enrollees statewide.
With this in mind, here's how things stack up in Louisiana for the ACA-compliant individual risk pool rate hike requests:
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
I've writte a lot about the so-called "woodworker effect" with Medicaid expansion over the past 2 1/2 years: People who were already eligible for Medicaid before the ACA, but who never signed up for it for a variety of reasons (they didn't know they qualified; didn't know the process for signing up; were too embarrassed to do so; etc etc). I estimated about 3 million "woodworker" enrollees in 2014, although I downshifted that later on and now have the tally estimated at around 3.8 million nationally as of the end of 2015. That's a lot of people being added to the system who would have been eligible for Medicaid even if the ACA had never been passed.
I haven't posted anything about Louisiana's ACA Medicaid expansion since back in January, just before newly-elected Democratic Governor John Bel Edwards took office. At the time, it looked like the program wouldn't actually kick off until July, and would enroll perhaps 300,000 people.
La. Governor Announces Medicaid Expansion Will Begin June 1, Save State $677M Over 5 Years
About 375,000 people in Louisiana are expected to enroll in the program for low-income residents. At the same time, officials in Arkansas continue wrestling with the governor's plan to end the political impasse over expansion.
Louisiana Gov.-elect John Bel Edwards has set an ambitious timeline for a Medicaid expansion, saying he wants to have government-funded health insurance cards in thousands more people's hands by July 1.
...that's assuming the Republican-led Legislature doesn't try to throw up any roadblocks seeking to slow down an expansion effort.
Edwards, a Democrat who takes office Monday, said he would issue an executive order "within 24 hours from being sworn in" that starts the work required to expand Medicaid as allowed under the federal healthcare law. Health coverage for the people who would be eligible for the insurance under the expansion, he said, would begin July 1.
...The incoming health secretary estimated that about 300,000 people, mainly the working poor, would be enrolled for Medicaid under an expansion.
Unlike the exchange QHP enrollments, which will always continue to be the heart and soul of this website (it's right there in the name, after all), I've kind of gotten away from trying to track Medicaid expansion on a granular level over the past few months. The main reason for this is that in many of the expansion states, they've simply maxed out on enrollees, and the numbers from week to week or even month to month are simply holding steady at this point.