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From left to right, Gov. John Bel Edwards, flanked by Dept. of Health and Hospitals Secretary Dr. Rebekah E. Gee, MD (center), shakes hands in January 2016 with his health care transition team co-chairs, Gary Wiltz, CEO of Teche Action Clinic, and Ronald A. Goux, president of the Louisiana Nursing Home Association, at the State Capitol after Edwards signed his his first executive order to provide for Medicaid expansion in the state of Louisiana.

The number of people enrolled in Medicaid expansion in Louisiana dipped again in August by about 4,300 people, continuing a months-long slide in enrollment as the state sends out the latest batch of wage verification letters that are part of a stricter enrollment system.

Since a peak of 505,503 enrollees in April, the number of people getting health care through the government-financed insurance program has fallen by nearly 55,200 people, or 11 percent, something the Louisiana Department of Health attributes to annual renewals and continued wage checks.

As part of the new enrollment system, the state performs wage checks for enrollees every three months and automatically kicks off the rolls those who don’t respond. The state earlier this week sent its third batch of letters to enrollees who appear to make too much money to be eligible, said LDH spokesman Bob Johannessen. Those people have 10 days to provide information proving they do qualify, or they will lose Medicaid coverage at the end of September.

Louisiana health department temporarily halts automatic closure of thousands of Medicaid enrollees

Enrollment has dropped steadily since April amid two rounds of wage checks that resulted in people losing coverage. Johannessen said the drop is likely a combination of continued losses in enrollment from wage checks as well as annual renewals.

Gov. John Bel Edwards expanded Medicaid shortly after taking office in 2016, a move that has become a central part of his platform as he runs for reelection as the only Democratic governor in the Deep South. The expansion extended health insurance to adults making less than 138% of the federal poverty line, about $16,600 a year for an individual or $33,900 for a family of four.

The new enrollment system, which was installed late last year, was designed to automatically close people out of Medicaid if they don’t respond to annual renewal letters. But earlier this summer, after months of the new enrollment system operating, LDH faced a backlog of information being sent from Medicaid enrollees and suspended the auto-closure feature for annual renewals. It kept in place the automatic closures for quarterly wage checks.

"We were concerned some people might be losing health care through no fault of their own, so we're taking a step back, being reflective and ensuring that everything people are sending us is getting processed before we close,” LDH Secretary Rebekah Gee said earlier this month.

That move kept 75,000 people from losing coverage immediately. Some people still lose coverage through the annual renewal process, but not because of the automatic closure system.

Email Sam Karlin at skarlin@theadvocate.com