With so much bad news about the state’s financial situation, there’s at least one win-win: expanding Medicaid health insurance for the working poor.
Gov. John Bel Edwards presented the bad news about the budget personally to the House Appropriations Committee on Tuesday. His appearance was itself noteworthy, as his predecessor Bobby Jindal was rarely in the State Capitol corridors and much less so when the news was bad.
But in one significant reversal from Jindal’s policies, Edwards said the state can get higher federal reimbursements for health care by expanding Medicaid insurance.
It is a battle long fought at the Legislature, where a GOP majority and Jindal officials continually blocked the expansion. Few people working in low-wage jobs can afford traditional health insurance, even if it is offered by an employer; when workers get sick, they are likely to put off care and end up in an emergency room.
The latter is a high-cost option that is ultimately paid for, either by shifting costs to other customers or by direct state payments for uninsured care.
Medicaid gets individuals, perhaps 300,000 of them in Louisiana, out of that trap.
The good news Edwards told the appropriators is that the state expects to save $184 million the fiscal year beginning July 1. That’s because the Medicaid expansion authorized under the U.S. Affordable Care Act, commonly known as Obamacare, pays a high matching rate with federal funds. “As we move forward with expansion, Louisiana will begin to see savings that we have spent years denying,” the governor said.
That’s one of the reasons to support Medicaid expansion, although there are knowledgeable critics of the proposal, including a former state senator, Bill Cassidy, of Baton Rouge, now in the U.S. Senate. A key argument is that the budget savings will be fleeting because utilization of services will go up, raising costs — ultimately, whether state or federal, paid for by taxpayers.
We believe that is a bonus, if the outcome is healthier workers. We shall have to see how Medicaid expansion works in practice over several years, but the reality is that Louisiana has a large population of poor families, working in low-wage jobs.
By law, those folks are not going to be turned away from emergency rooms if their health goes bad. Costs for everyone in the system will be lower if the Medicaid card encourages people to go to the doctor first, getting cheaper care in an appropriate medical “home” for each family.