In the two years since Louisiana expanded its Medicaid health care program, more than 400 women enrolled have been diagnosed with breast cancer and are receiving treatment.
Nearly 8,000 adults have had precancerous colon polyps removed, and another 330 are being treated for newly diagnosed colon cancer.
More than 57,000 people are receiving mental health treatment, and more than 21,000 people have received substance abuse treatment.
"This is about saving people's lives," Health Secretary Dr. Rebekah Gee said in a recent interview with The Advocate.
With the stroke of Gov. John Bel Edwards' pen shortly after taking office, thousands of people became qualified for Medicaid on July 1, 2016.
More than 477,000 people, mostly the working poor, are on the state's rolls today under the expansion, which has started to see enrollment level off last month after consistently seeing increases-month-over-month.
Expansion, an optional part of the federal Affordable Care Act, made Medicaid available to adults with income below 138 percent of the federal poverty level, about $34,600 annually for a family of four or $16,700 for a single person.
Before Medicaid expansion, one out of every four Louisiana adults didn't have health care coverage. Today, the uninsured rate has shrunk to about one in 10, Gee said. "This was a very historic and monumental shift in health care for the state of Louisiana," Gee said.
Gee said she sees ripple effects across the state — people get mental health treatment, which makes communities safer; workers are healthier so they are more productive; people aren't bogging down emergency rooms because they have a cold.
Against all odds, Louisiana has become the 31st state — perhaps more noteworthy, the first state in the Deep South — to expand Medicaid throug…
"It matters a lot to have insurance," she said.
But it hasn't been without its detractors.
Medicaid, which includes health care programs for medically fragile children and adults with severe disabilities, makes up nearly $9 billion of Louisiana's $29 billion budget — much of that from federal funds.
The price tag, and explosive enrollment growth since the start of expansion, has made it a target, particularly among Edwards' Republican critics.
Rep. Tony Bacala, a Prairieville Republican who serves on the House Appropriations Committee, has been one of the most outspoken Medicaid skeptics.
"Unless the economy vastly improves, we have to come back and say, ‘We're going to raise your taxes again because of health care costs,’ ” Bacala said during a Department of Health budget hearing last month. "How long can we maintain the state when every year we have to come up with an extra match?"
"We're going to have higher state costs very quickly," he added.
Bacala stressed to LDH officials that even a fraction of the health care budget could drastically impact the state's bottom line.
On the last day of the third special session this year, Sen. Sharon Hewitt, a Slidell Republican who is considering running against Edwards in next fall's gubernatorial election, specifically called out Medicaid expansion as a source of the state's fiscal woes.
"The governor's decision to expand Medicaid without any consideration for the cost of doing so has grown the cost of health care in Louisiana at the expense of other important priorities," she said. "Medicaid is the single biggest expenditure in state government. If we don't rein in the cost of health care Louisiana will be in a constant fiscal crisis."
The remarks prompted an unusually blistering rebuke from Edwards during his session-ending news conference, who said of Hewitt: “Maybe if she doesn’t want working poor people to have health care she should just say it."
Gee said she believes that many people misunderstand Medicaid. LDH's website includes a "testimonials" section that details stories from college students, waitresses, people who have been recently laid off from their jobs and others who have received lifesaving treatment from Medicaid expansion.
"It's difficult for people to make ends meet who are making even minimum wage," Gee said. "I think there's a misunderstanding about what people's lives are like."
The state Medicaid program has repeatedly been the subject of questionable audits and has often been accused of teeming with fraud.
U.S. Sen. John Kennedy, a Madisonville Republican who says he's considering a run for governor against Edwards next year, released an op-ed this week in which he decried the state's management of Medicaid post-expansion.
"The state isn’t strapped for cash because you need to pay even more in taxes," Kennedy wrote. "The state is strapped for cash because it can’t competently manage a program that consumes nearly half the state budget."
Gee and other LDH officials have repeatedly denied that the program is mismanaged and continue to adjust to meet critics concerns. After an audit highlighted that the state had one of the highest income compatibility thresholds, meaning the amount that someone might make over the eligibility limit, the department is in the process of cutting the limit by more than half.
"We take very seriously the integrity of our program," Gee said.
But she said she feels most attacks on Medicaid are politically motivated.
"At the end of the day, we are talking about people getting health care," Gee said. "This is not people taking money bags out of an office."
"I think it's just people don't understand the driving force why people get on Medicaid. The more you walk in people's shoes, the more you understand why people need Medicaid," she added.
Louisiana long resisted expanding Medicaid under Edwards' predecessor, Republican Bobby Jindal, but there have been no large-scale efforts to reverse Edwards' executive order. Polls have consistently shown overwhelming support for expansion in Louisiana.
Gee said that LDH often hears from other state officials who see Louisiana as a model for the program.
Last November, Maine became the 33rd state to agree to expand Medicaid after a vote of the public showed support. The state's governor has continued to block the effort. Months later, Virginia's Legislature voted in favor of expanding the health care program for the poor. Several other states that have resisted expansion are considering it.