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Advocate staff photo by TRAVIS SPRADLING – Gov. John Bel Edwards signs the first executive order of his new administration at the State Capitol, No. JBE 16-01, which provides for Medicaid expansion in the state of Louisiana.

Travis Spradling

Louisiana is one of 10 states that have seen the steepest decreases in the rate of uninsured residents over the past four years, according to survey findings released Wednesday.

The 2016 Gallup-Healthways Well-Being Index found that Louisiana's uninsured rate fell to 12.5 percent last year — down from 21.7 percent in 2013.

The survey's researchers note that all 10 states that saw their uninsured rates drop have expanded Medicaid through the federal Affordable Care Act.

Louisiana's Medicaid expansion took effect July 1, following an executive order that Gov. John Bel Edwards signed shortly after taking office in January 2016. 

The Gallup survey was conducted throughout 2016, so half of it was prior to the expansion taking effect and half post-expansion in Louisiana. Nearly 400,000 people are currently enrolled under the expanded criteria, according to the Louisiana Department of Health.

"Medicaid expansion is working, and in the process, Louisiana is saving more than $184 million," Edwards said. "This is great news for the more than 394,000 working poor people of Louisiana who've been denied health coverage and are now getting the care they need. We're saving lives in Louisiana and these numbers are proof of that."

Louisiana still had the 11th highest rate of uninsured residents last year, the Gallup survey found. None of the 10 states with higher uninsured rates in 2016 has expanded Medicaid.

Louisiana's 9.2 percent fall was bested only by Montana, Arizona, Washington, Oregon, California, New Mexico, West Virginia, Arkansas and Kentucky – all states that expanded their Medicaid programs through the federal Affordable Care Act before Louisiana did in July.

"This is a real generational shift for Louisiana," State Health Secretary Rebekah Gee said. "It's very good news for our state ... It's a great direction to be heading in."

According to the Louisiana Department of Health's latest Medicaid expansion statistics, more than 58,000 new Medicaid patients have sought preventive care or new patient services since enrolling. More than 125 people have been newly-diagnosed with either breast or colon cancer and are now getting treatment. Additionally, 1,193 people have been diagnosed with diabetes and 2,954 with hypertension. Gee said such diagnoses will prevent more serious health issues, such as heart attack and stroke.

"These are real people, real numbers, real lives," Gee said.

Gallup's findings are based on daily surveys conducted from January to December 2016. Included in the survey were 2,426 Louisiana residents.

Louisiana's uninsured rate has often been cited among the nation's highest prior to expansion.

The Louisiana Health Insurance Survey has reported about one in five adults here didn't have health care coverage in estimates dating as far back as 2003, when the LSU-based survey first began, and as recently as its latest report released in August, which didn't include the expansion population.

Under the expansion, which is an opt-in provision of the federal Affordable Care Act, adults who make less than 138 percent of federal poverty level — about $33,500 a year for a family of four or $16,200 for a single adult — can qualify for free health care coverage.

The federal government paid 100 percent of the costs for the state's newly-enrolled through the end of 2016, and the state gradually will take on up 10 percent of the costs by 2020. Under current federal law, which faces an uncertain future under Republican President Donald Trump and GOP-controlled Congress that has vowed to repeal President Barack Obama's signature health care law, the state will never pay more than 10 percent for the expansion population.

Because of the higher cost share, the state was able to shift money, freeing up $184 million in the budget for other state expenses, Edwards has often noted.

Republican leaders in Washington haven't revealed what the future of Medicaid expansion will be under a plan to replace the Affordable Care Act.

Edwards, a Democrat, signed the executive order to expand Medicaid through President Barack Obama's signature health care law after Republican Bobby Jindal had refused to expand during his two terms in office.

The Louisiana Department of Health had initially sought to hire more employees to beef up enrollment efforts and promote the expansion but because of budget constraints instead tried other avenues that Gee called "creative and effective" alternatives, including direct outreach to food stamp recipients and others likely to qualify.

"Louisiana can be a pioneer and can be successful," Gee said.

Follow Elizabeth Crisp on Twitter, @elizabethcrisp.