I think you simply need to read between the lines of a couple recent Advocate articles to figure out where the current midyear budget cuts are headed....

"Edwards said that multiple statewide officials have approached him, willing to take deeper hits to their budget to spare other state services." ...yet in the final paragraph of the same article the LDH secretary is quoted as saying... "We’re putting together various budget scenarios. We have to be prepared,” Gee said. “And we’re explaining to legislators why we need more revenues."

Now retreat to a mere 60 days to November 3...."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." Unfortunately, the Advocate has yet to follow up on that press release, because LDH immediately revised their numbers following their October PR push. When the anticipated fiscal report was compiled in December, it was quietly noted that the roughly $3 million surplus was revised to a $300 million deficit. That number has been further revised in the January report, which currently stands at a $340 million deficit for the current fiscal year.

Your level of concern for the looming budget problems will probably hinge upon whether you are for/against Medicaid expansion. The LDH secretary continues to pen editorial pieces supporting the benefits of expansion. "Today, more than 336,000 Louisianans have access to health care that they didn’t previously have. Already, there have been more than 24,000 preventive care visits, approximately 2,200 women have received breast cancer screenings that resulted in 28 diagnoses, and 288 adults have been newly diagnosed with diabetes and are receiving treatment." Interestingly, I've yet to see the Advocate inquire "how much does it cost everybody else for each newfound benefit?"

Fortunately, with managed care, the numbers can be pretty easily interpolated since the state pays a monthly premium for each Medicaid recipient. (The cost varies according to age and other factors, but for simplicity's sake, you can conservatively assume ~$500/mo. per recipient.) Using those numbers, the state is paying premiums for a projected addition of 336,000 residents which equates to approximately $168,000,000/mo. For that cost, they're currently touting the benefits that roughly 7% of the newly insured population has used the newly acquired benefits for preventative screenings. Certainly nobody is unhappy to hear 2,200 women were screened for breast cancer which resulted in 28 diagnoses that wouldn't have otherwise occurred. The question becomes, at what cost? Are those 28 diagnoses worth the additional $2 billion annual investment?

The next looming question will be "how many expansion recipients will there be in this state?" The initial projections were ~350,000, but last week, during the legislative hearings, LDH revised their projections to 450,000 by July 1, 2017. ...That begs the question, LDH's budget projections shifted $300 million in the last 120 days. Fortunately FedGov will cover 100% of the expansion cost this year. But, what happens next year when the state has to fund 10%, and will the under projection of 350,000 new members actually end at the current expectation of 450,000?

If the answer is no, are this state's citizens willing to forego education and possibly every other publicly funded service to satisfy healthcare obligations?