As a strong believer in cutting waste in government, I am always happy to hear that a taxpayer-funded program has identified inefficiencies and trimmed the fat accordingly. So, why do I find myself less than enthused about the recent report touting supposed spending reductions to the Medicaid expansion program? The answer is simple — we should’ve never reached this point in the first place, and we’re being misled about the depth of the fraud and abuse running rampant throughout the program.
When expansion was first introduced, initial expansion enrollment projections totaled 306,000 Louisianans. Since then, projections have risen to more than 457,000 individuals, and the Louisiana Department of Health claims the projections were always that high. It gets worse.
Last legislative session, LDH predicted a growth in Medicaid enrollment, yet the most recent post-session report projects a decline. Why the sudden reversal? Note that a majority of the projected decline comes from the expansion population, which LDH signed up itself. LDH is essentially bragging about cleaning up a mess of its own creation.
When there are those who are uninsured and have no ability to seek medical care, government picks up the tab or it is absorbed by the private sector. This is called uncompensated care (UCC). Other states that entered into Medicaid expansion saw a sizable decrease in UCC expense, while here in Louisiana UCC has increased. LDH attributes this to the rising cost of medical care, but such costs have increased nationwide. So, why hasn't our UCC gone down?
Now, for the real million-dollar question: Why is the Louisiana Department of Revenue refusing to share the data it provided Medicaid task force members in 2017, which proved there were problems with waste, fraud and abuse in the system? The state legislative auditor has even gone so far as to file a lawsuit to get this information, yet LDR refuses to hand it over.
From the beginning, Louisiana’s conservative legislators have simply asked that Medicaid expansion serve those most in need. Since then, scathing report after report has revealed that this was not the intention of this administration. The Pelican Institute recently revealed in a report that thousands of individuals per month are dropping their private insurance plans to join the taxpayer-funded program. What’s worse, there are more than 1,000 individuals enrolled in Medicaid who earn annual salaries of $100,000 or more. Medicaid expansion’s original intention was to help those who needed it most, but those are the ones greatest impacted as we expand eligibility while providers shrink.
I encourage all taxpayers to ask the tough questions of our leaders. It’s beyond time we get to the bottom of what’s really going on with Louisiana Medicaid expansion.