Ralph Abraham: It’s time to be honest about Louisiana Medicaid Expansion

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As a practicing physician in a poor, rural area of our State, I know first-hand how important it is to make sure all Louisiana residents have access to affordable, quality health care. But the growth trajectory of John Bel’s Medicaid expansion plan is going to hurt those it is intended to help by reducing access and bankrupting our State.

While running for governor, John Bel Edwards promised Louisianians that he wouldn’t raise taxes. But just months after taking office, he imposed the largest tax hike in state history.

Four years later, Edwards is once again campaigning on a lie that will have devastating consequences for our state.

This time, Governor Edwards tells us that we don’t need to worry about the soaring cost of Medicaid expansion in our state.

But unlike Edwards, the numbers don’t lie. And they show that his Medicaid expansion costs will bankrupt our state if we don’t get a handle on it.

State spending on Medicaid is growing at a faster rate in Louisiana than any other state in the country. The Louisiana Department of Health’s budget has grown by an average of 10.5% every year since Governor Edwards took office. That equates to an additional $1 billion of spending every year for the last four years. One. Billion. Each. Year.

The Louisiana Department of Health’s budget now takes up over 50% of our total state budget. That means there’s limited resources to invest in other critical areas like infrastructure, education, help for the physically and mentally disabled and natural disaster recovery.

And it’s only getting worse. Starting in 2020, the percentage of state matching dollars that Louisiana will have to provide for Medicaid expansion will increase from 7% to 10%. In a multi-billion dollar program, 3% is a big number. Governor Edwards has no plan to pay for this. LDH has admitted that we are going to have to start tapping into limited state general fund dollars to fund Medicaid expansion, but they’ve never mentioned how much, and they haven’t budgeted for it.

According to the Edwards administration’s initial estimates, roughly 300,000 were eligible for Medicaid expansion. Now, over 500,000 have signed up for the program, and the numbers are expected to continue growing. Roughly 4 out of every 10 Louisiana residents are on government funded healthcare right now. It won’t be long before that number passes 50%. Either his administration flat out lied about the cost of the program, or they didn’t know. I don’t know which one is worse.

What I do know is that the legislative auditor has already uncovered that the Louisiana Department of Health wasted at least $85 million on people who weren’t eligible for Medicaid, including nearly 2,000 recipients who make more than $100,000. That doesn’t include working individuals with good private insurance who have dropped their coverage for free government health care.

The soaring cost of Medicaid expansion alone is alarming. But the lack of transparency may be the worst part. Earlier this year, LDH admitted to underestimating expansion costs by more than $400 million. They slipped that in at a legislative Medicaid subcommittee hearing. Just last month, Governor Edwards’ administration admitted that they have no ability to track another $420 million they are handing over to Medicaid Managed Care Organizations through an “incentive” program. that pays the MCOs to deliver good healthcare outcomes. Not only are we already paying the MCOs more than $8 billion to achieve quality outcomes, but even worse, LDH admitted that they have absolutely no clue how the MCOs are actually spending the money. That’s unacceptable.

I believe it’s our responsibility to take care of those who cannot take care of themselves and give a hand up to those who need it. That is not what this Governor has done. Despite Edwards’ claims of balancing the state budget, he’s driving the state right over another fiscal cliff. That doesn’t help anyone.

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