The Louisiana Department of Health and the state's Medicaid program are in one of the strongest financial positions in six years, after the state opted to expand Medicaid through the federal Affordable Care Act, a new report shows.
LDH's fiscal forecast report predicts that, because of the infusion of federal dollars tied to Medicaid, the department will end the budget cycle next June with a modest $2.85 million surplus, after facing deficits in five of the previous six years.
That's on top of the $184 million boost that was calculated into the state budget, based on savings from Medicaid expansion.
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The surplus only exists because of federal funding, the report shows. LDH is on track for a $394.6 million shortfall in state-only funding. That's down from the $561 million shortfall predicted in the forecast at this point last year, but still indicates that the program is costing more than expected when state lawmakers crafted the budget.
The fiscal report also provides some additional insight into the Medicaid expansion population three months in. The state had set a target goal of enrolling 375,000 new people under the expanded criteria in its first year. Now, the state is on track to hit 402,333 new adult members by the end of June. The current tally is 331,763.
The expansion population is also trending older than was initially expected, which means it's costing the state more per month than anticipated, the report reveals and cites as one of the driving factors behind the state-side shortfall.
"At the same time, fewer pregnant women and people with disabilities are enrolling in the non‐expansion program than originally estimated because they are enrolling in expansion instead,resulting in a surplus of $20.7 million in payments to managed care organizations for the non‐expansion population," the report notes.
Gov. John Bel Edwards, a Democrat, signed an executive order expanding Medicaid shortly after taking office in January. Enrollment began in June, with coverage beginning in July.
Louisiana is currently experiencing what is likely to become its first significant increase …
Adults who make below 138 percent of the federal poverty level — about $33,500 a year for a family of four or $16,200 for a single adult — are among the newly eligible population.
Previously, childless adults were not eligible for Medicaid in Louisiana, and the income restrictions for people with children were tighter.
Under the federal health care law, the federal government will pick up 100 percent of the tab for the state’s new enrollees through the end of the year. The federal match rate will gradually scale back to 90 percent, with the state picking up the other 10 percent by 2020.