LDH testimony at Appropriations 040919

Louisiana Department of Health Secretary Rebekah Gee, center, testifies Tuesday, April 9, 2019, about Medicaid expenses to the House Appropriations Committee.

The Louisiana Department of Health has sent out a second round of letters to 17,000 Medicaid recipients warning the people they will be booted off the health insurance program unless they prove they qualify.

And the agency is urging people to respond, after kicking more than 30,000 people off the program at the end of March, the vast majority because they did not reply to the first round of letters.

The letters are part of a new upgraded eligibility system for the Medicaid program that Gov. John Bel Edwards’ administration has said will address concerns the Medicaid program has spent millions on ineligible enrollees. Those concerns have heightened in recent months, as Republicans have used critical audits of the program to hammer the administration on Medicaid.

The health department sent its first round of letters as part of the upgraded system to 40,000 people in February, after determining from wage data they potentially earn too much to qualify for Medicaid. At the end of March, more than 30,000 people lost their health coverage because of the checks.

Most of those people were non-elderly adults covered under Medicaid because of Edwards’ expansion of the program, which took place in 2016 shortly after he took office. After reaching a high of 505,000 enrollees in Medicaid expansion, the figure dropped to 464,871 as of May 8, according to LDH data.

The new batch of 17,000 people have until June 30 to provide information proving they qualify for Medicaid, LDH said. If they don’t respond, or if they don’t qualify, they will be kicked off the program.

“We really need them to respond,” said Medicaid director Jen Steele, who added the agency has boosted its call center staffing to deal with the influx of calls from enrollees.

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The letters tell recipients their Medicaid coverage status is “pending,” and that they need to call or send information proving they are eligible for the program.

While the vast majority of those lost coverage in March were kicked off because they did not respond, about 7% have since come back onto the rolls because they proved they qualify, Steele said.

In the coming months, Steele said more still could come back on the rolls as they learn they have been kicked off Medicaid.

The health department is also trying to “strike the right balance” of having a robust wage verification system while also not kicking off people who actually qualify for Medicaid, Steele said.

Instead of checking the rolls annually, as was previously done, the health department now uses quarterly wage data to verify the state’s Medicaid enrollees don’t make too much money to qualify for the program. Every three months, the agency sends letters to those who appear to make too much money, asking them to prove they actually qualify or else be booted off the program.

The wage data comes for Louisiana Workforce Commission. In the next 30 days, the agency will also begin using tax data from the federal government, said LDH spokesman Bob Johannessen.

The governor expanded Medicaid to about half a million people with an executive order shortly after taking office. While the expansion is nearly all funded by federal dollars, the state pays for its portion with a tax on providers and Managed Care Organizations.

Edwards, who is running for re-election as the only Democratic governor in the Deep South, has consistently touted Medicaid expansion. At his "State of the State" address to begin the current legislative session, Edwards brought a Medicaid recipient who benefited from the expansion as a guest.

Republicans have attacked the Edwards’ administration handling of the Medicaid program following a report from the state’s legislative auditor that said the health department may have spent $85 million over 20 months on health care coverage for people who didn’t qualify. Democratic lawmakers have criticized the methodology of the report.

That criticism comes amid a health department budget that is set to grow by about $1 billion in the current budget proposal for the fiscal year beginning July 1. The increase is nearly all from federal money related to Medicaid payments.

Shortly after the audit came out in November, LDH installed the new wage system, which was already in the works before the report.


Follow Sam Karlin on Twitter, @samkarlin.