Open Letter On Louisiana Medicaid Expansion

Medicaid Expansion is the Right Choice for Louisiana

November 15, 2014

To: Governor Bobby Jindal, State of Louisiana, Senator David Heitmeier, Chair of the Louisiana Senate Health & Welfare Committee, Representative Scott Simon, Chair of the Louisiana House Health & Welfare Committee, Senator John Alario, President of the Louisiana State Senate, Speaker Chuck Kleckley, Speaker of the Louisiana House of Representatives, Secretary Kathy Kleibert, Secretary of the Louisiana Department of Health and Hospitals

From November 15 to 19, 2014, the American Public Health Association (APHA), a diverse community of public health professionals who champion the health of all people and communities, will be hosting its 142nd Annual Meeting and Exposition in New Orleans, Louisiana.  Local, state and national public health leaders will convene in New Orleans on Nov. 15 to host a Day of Action to express our support for Medicaid expansion in Louisiana.  

Currently, 1 in 4 adults lack health insurance coverage in Louisiana.  Medicaid expansion could immediately cut that figure in half.  According to Families USA and the Louisiana Consumer Healthcare Coalition, this year Louisiana had the unprecedented opportunity to provide about 422,000 currently uninsured, low-income Louisianans access to affordable health care through Medicaid expansion, but it did not.   

We are concerned. According to the U.S. Office of Women’s Health, Louisiana ranks at the bottom in many health outcomes among all 50 states, DC, Guam and Puerto Rico: 53rd in obesity, 51st in total cancer deaths, 50th in heart disease and diabetes-related deaths, 50th in lack of preventive dental care, and 49th in high smoking rates.

Meanwhile, we are seeing evidence nationally that the Affordable Care Act (ACA) and Medicaid expansion are working.  According to the Centers for Disease Control and Prevention (CDC), health coverage has improved in the 27 states that have implemented Medicaid expansion.  Recent National Health Interview Survey data have demonstrated gains in insurance coverage rates (3 percent nationally) among American adults previously uninsured in just the first quarter of 2014 since the ACA Medicaid expansion and the marketplace went into effect this  January. These coverage gains are significantly higher in states that have embraced Medicaid expansion.  Louisiana, and other states not participating in Medicaid expansion, continues to be left behind.

We know from experience that Medicaid expansion works in Louisiana.  Since the late 1990s, the Louisiana Children’s Health Insurance Program (LaCHIP) has helped reduce the uninsured rate for Louisiana children from 20 percent to 5 percent.  Now it’s time to insure the health of adults.  

The benefits of Medicaid expansion can be secured at modest cost to the state.  The federal government will cover 100 percent of expansion costs through 2016, with the state contributing a small portion after that, but never more than 10 percent.  That’s much better than the rest of the Medicaid program, where the state share is around 35 percent.  Adding urgency to this situation is the fact that cuts to the Disproportionate Share Hospital (DSH) funds that Louisiana currently relies on to support indigent care are likely to occur as the Affordable Care Act takes full effect.  Without expansion, Louisiana taxpayers and health care providers will continue to carry the cost of providing uncompensated care to uninsured patients.

As public health professionals and community leaders we believe the United States can become the healthiest nation in one generation, but only if we dedicate ourselves to improving the health of all.  We urge you to support Medicaid expansion in Louisiana to improve Louisiana’s health, and economic health.

For America’s health and economic well-being,

Cc:  U.S. Senator Bill Cassidy, U.S. Senator David Vitter, My U.S. Senators, Advocacy Center, and Louisiana Center for Health Equity


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