By: Kevin Boyd
The end result of this acceptance of Obamacare’s Medicaid expansion is that it will cost the state more money than projected. Given that the state is already facing a nearly $2 billion deficit this coming year and likely another massive deficit the following year, this makes Louisiana’s budget situation even worse.
From the Times-Picayune:
The Department of Health and Hospitals is now forecasting that Louisiana’s Medicaid rolls could swell to nearly 450,000 people after initially projecting that as many as 300,000 uninsured could be covered under the federally funded program.
The department had originally based its projections based on U.S. Census data that counted about 306,000 people as uninsured. But there is also a population of about 130,000 people who are part of the state program who are eligible to receive screening and treatment for sexually transmitted infections (STI) even if they aren’t eligible for Medicaid coverage.
That population, said Medicaid interim director Jen Steele, was always counted as part of the 306,000 that reported themselves as uninsured.
Meanwhile, the state is planning to save some money by moving those covered by Bayou Health into the Medicaid expansion.
Under Medicaid expansion, a new group of patients who were previously uninsured will receive Medicaid coverage at a much lower cost than those in Bayou Health: The federal government covers all Medicaid costs until 2017. Then the state begins a paying 5 percent of the costs, gradually increasing the matching funds to a cap of 10 percent in 2020.
But some of the people in Bayou Health — pregnant women, primarily — could be considered eligible for both Bayou Health and the expanded Medicaid program. Those patients will be moved under the Medicaid expansion umbrella where the state will pay the 10 percent match instead of the 38 percent match that begins in 2020.
That could push the numbers higher, possibly as high as 470,000, Steele said.
Even so, as more people join the program, the state’s savings will diminish because it’s paying for a larger number of people in the program, Steele said. This has been an issue in other states such as Kentucky, where Medicaid expansion enrollment numbers have been much larger than projected, according to The Associated Press.
These projected numbers do not take into account one group of people: those who will be thrown off of private insurance and into Medicaid. As Obamacare continues to devestate private employers, more and more businesses are going to simply choose to pay the fines instead of providing insurance to their workers. Those workers will be either be thrown into Medicaid or will be thrown into the Obamacare exchanges.
Plus as the debt problem continues to develop in Washington, Medicaid could be on the chopping block. States could be asked to pay more. For a state like Louisiana that already has structural budget problems, the reduction in Federal matching funds could blow another big hole in the state’s budget.
To accept Medicaid expansion without reforming Louisiana’s budget was foolish. For the Federal government to offer Medicaid expansion without reforming the program was equally foolish.
UPDATE (1:49 PM): Kristina Ribali of the Foundation for Government Accountability, which is fighting Obamacare’s Medicaid expansion all across the country, just sent this quote to us:
“There simply are no reliable enrollment or cost estimates, and as we’ve seen in every expansion state where there’s data publicly available, they’ve already exceeded their maximum enrollment projections.”
“Legislators should be extremely wary as higher than expected enrollment means much higher costs to taxpayers.”