PAR: More Info Needed to Make Medicaid Expansion Decision for Louisiana
The state legislature’s Joint Insurance Committee met Wednesday to discuss the Affordable Care Act and two crucial, yet voluntary, measures: setting up state health insurance exchanges and expanding Medicaid.
At that meeting a representative from the Public Affairs Research Council said Louisiana doesn’t have enough information to make a truly informed decision on implementing the healthcare reform law.
PAR’s Principle Health Advisor Don Gregory recently authored a study about the research done so far on the implications of expanding Medicaid in Louisiana. He says other states have worked to figure out not just the costs, but also the benefits of insuring the uninsured.
GREGORY: Other states have done more; Arkansas has done estimates of what the impact would be on state revenue. From the expansion in that state they estimate that they would gain $250 million over about a 10-year period. The state of Georgia has looked at what they would gain in the way of revenue from the premium tax, which is in existence there. And we have a similar tax here in Louisiana. They estimate in Georgia about $70 million a year when it’s fully implemented. Those analysis have not been done here.
WESTERMAN: What are some of the specific things that Louisiana needs to consider when looking at cost savings?
GREGORY: PAR lays out in the support many of those things. A broad analysis, we need to look at what the impact would be on the private insurance market in this state. We need to look at what the long-range commitment for state revenue would be. We need to look at what benefit we would gain in the near term – it’s hard to think of the near term as being 10 years – but in the near term of 10 years what the cost differential would be in the choice to expand or not to expand. There will be costs because the Supreme Court did not make the rest of the law option. There will be costs associated with the implementation of ACA.
WESTERMAN: Medicaid expansion is set to go into effect at the beginning of 2014. What happens if Louisiana decides to expand Medicaid after that deadline?
GREGORY: Well, there is a financing provision in the law that provides for 100 percent federal funding for the first three years. That’s 2014-2016. So that if we joined later, we’ll miss part of that window of opportunity to have 100 percent federal financing, but we can still join at any time. If we decided to join in 2017, then we would pay 5 percent and the federal government would pay 95 percent of the cost for that year.
WESTERMAN: When Governor Christie decided to expand Medicaid for New Jersey, he said it was a state-specific issue. What about Louisiana would make Medicaid expansion either good for it or maybe not so great for it?
GREGORY: Well, we have a large number of adults in our state that are uninsured. When you lack health insurance, you lack the ability to have preventative care. Most of your care tends to occur when you’re in acute crisis. It occurs in the emergency room or occurs somewhere within the LSU hospital system. And so it’s an expensive delivery model. I think you’d get better health outcomes for the people who are uninsured if they had access to primary care. These people are, for the most part, working. They’re working for low wage jobs. So their performance in their jobs would be better and it would improve if they didn’t have acute health issues that they have to deal with. So, I think you get a healthier workforce and that’s what we all want.
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