Louisiana: ACA Medicaid expansion breaks 265K

I'm finally taking a break for my final batch of 2017 Rate Request states to focus on some good news out of Louisiana:

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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“People have needed coverage here for a long, long time,” said David Hood, who served as state health secretary under a Republican governor from 1998 to 2004. “This is long overdue.”

As of the beginning of August, 265,723 low-income Louisianians have newly signed up for Medicaid, according to state officials.

As a reminder, a good 70% of these enrollees were actually transferred over automatically from existing state-funded healthcare programs, so they might not technically be considered "newly" covered...except that those other programs didn't necessarily include anything close to comprehensive coverage, so this is still a massive upgrade for the enrollees.

In any event, this means that Louisiana has already enrolled over 2/3 of the total number of residents estimated to be eligible for ACA Medicaid expansion. If they add 740 people per day, they'll be maxed out by the end of this year.

Noam Levy's L.A. Times article also helps put a human face on what these numbers actually mean for people:

Dr. Sarah Candler, who worked as a primary care physician at another safety-net clinic in the city, said she cried with one of her patients who recently learned she would get the new Medicaid coverage.

“It was like I got to tell her I cured cancer,” said Candler, who said the woman had routinely postponed recommended screenings and put off filling her prescriptions because she couldn’t afford them. “It was so powerful to be able to say that I could fix at least one of the things that was making her sick.”

For Cherry Jackson, a 55-year-old New Orleans native who had been living in a homeless shelter, the Medicaid coverage has helped her get medicines she needs to control her high blood pressure and diabetes.

“Every time my doctor would give me a prescription, I couldn’t pay for it,” Jackson said. “I thank God for this program.”

There is growing evidence nationally that Medicaid coverage is affecting patients, as previously uninsured Americans like Jackson begin to get recommended medical care and more routinely take their medications.

After Kentucky and Arkansas expanded their Medicaid programs in 2014, for example, researchers found poor patients there skipped fewer medications and were more likely to get regular care if they had a chronic illness such as diabetes.