I write this letter in hopes that the governor will alter his position and opt to expand Medicaid eligibility for adults, as provided for in the Affordable Care Act.

This administration has undertaken a massive redesign of public education under the mantra of providing choice for parents whose children are in failing schools. I point this out, not to argue whether the reform is positive or negative, but to suggest that there is another area where public policy should support choice — and that is in health care.

A working poor and uninsured person needs to have a choice, and a Medicaid card provides such a choice. Under present policy, the only option for such an individual is to go to the nearest public hospital. With those hospitals closing and/or converting to public/private partnerships, the choice is then limited to whatever arrangement can be cobbled together with temporary fixes that may be very short term.

Another initiative of the administration is to streamline the tax structure. Again, this letter is not to suggest a pro or con position on taxes. Instead, it is to suggest that the Medicaid expansion provided for in the Affordable Care Act is a very streamlined way to cover the working poor with meaningful health insurance. It can be implemented at no cost to the state for the first three years and at a 10 percent match after that. Some, if not all, of the current provisions that are being used to dodge the expansion will eventually go away. We may have no alternative but to expand Medicaid down the road but we will have lost the benefit of the first three years at no cost.

And finally, I would hope that the governor will be moved to follow the lead of Pope Francis and open his heart to the poor. An unexpected layoff, a serious automobile accident, or any number of other calamities could easily cause any one of us to be among the number of Louisiana citizens who can benefit from a Medicaid expansion.

Sandra C. Adams

retired health care lobbyist

baton Rouge