Gov. John Bel Edwards’ decision to accept millions of dollars in new federal Medicaid money should help expand access for the poor people who depend on Medicaid for health care.

But accepting the new Medicaid money is only the first step in improving health care for Medicaid recipients. Access also requires attention to many other issues that aren’t easily resolved. Addressing those challenges will be a continuing problem for the policymakers in Edwards’ administration.

That reality was evident recently when administration officials unveiled a plan to sign up patients eligible for the new Medicaid money. The state is so cash-strapped right now it can’t easily handle the short-term cost of hiring workers to enroll those covered by the Medicaid expansion. The estimated price tag for the enrollment initiative is $2.8 million.

That’s why administration officials are asking health care providers to cover the cost instead. The unconventional proposal requires federal approval before any of the estimated 248 workers needed to staff the Medicaid expansion can be hired.

We have supported Medicaid expansion in Louisiana, but it’s clear that expansion is a means to an end, not an end in itself. Fulfilling the program’s goals won’t be easy.

A recent story from the Sarasota Herald Tribune about Florida’s Medicaid program should be required reading for Louisiana government and civic leaders. It’s available here: http://medicaid.heraldtribune.com/2-million-kids-24-billion-battle/.

The story detailed access nightmares for Medicaid recipients, many of whom had trouble finding doctors who would accept Medicaid insurance. As Herald Tribune reporter Maggie Clark told readers, “a developmentally delayed child with AIDS was told to wait six months to see an ear, nose and throat specialist, even though his ears were throbbing and he was screaming in pain. A 3-year-old child with pancreatic disease and chronic tooth decay was dropped from his dentist, who stopped accrediting Medicaid patients. While his mother searched for another dentist, the tooth decay had so diminished the boy’s appetite that he was only drinking milk.”

U.S. Sen. Bill Cassidy, R-Baton Rouge, has pointed to the availability of doctors willing to accept Medicaid patients as a big problem. “I’m all for covering people; it’s just that Medicaid is a broken system,” Cassidy recently told The Advocate editorial board.

We support mending Medicaid rather than ending it. But clearly, getting new Medicaid dollars is just the first hurdle for the new governor. Translating those new dollars into effective health care means many hurdles to come.