While expanding Medicaid coverage is going to be a chore in some places for health care providers, Gov. John Bel Edwards’ decision to expand the program to the working poor will benefit Louisiana both in the short run and in the longer term.
The state’s fiscal years run from July 1 to June 30, so effective last month, the new coverage will apply to hundreds of thousands of individuals who typically work at low-wage jobs without insurance.
The expansion is not universal. Under the Affordable Care Act, the federal government pays the cost up to 134 percent of the federal poverty line. Over time, the state will have to put up 10 percent of the program cost.
That’s the short-term benefit, as the federal government matches most Medicaid costs at about $2 for every $1 the state spends. The higher match rate will help out the state’s budget to the tune of $184 million in the new fiscal year.
But the long-term gains of Medicaid expansion are quite possibly of greater importance.
The Louisiana Department of Health says that the state benefits in manifold ways from the expansion. The populations served range from convicts doing time in prison because of untreated mental conditions to poor mothers who typically would lose coverage shortly after their children are born.
With nearly 70,000 people behind bars across the state, Louisiana’s incarceration rate dwarfs most states in the country. That’s a rate of about 816 people per 100,000 residents, compared with the national average of 392, according to the National Institute of Corrections.
“We have more opportunity to change and improve mental health services for this population than any other state in the nation,” said Rebekah Gee, a physician and head of the health department.
At the local level, collaboration with law enforcement and corrections is a way to treat mental health issues that too often result in arrests and crowded jails. In Lafayette, Baton Rouge and New Orleans, officials have been looking at better ways to deal with the mentally ill clogging the system; Medicaid expansion may make those initiatives more financially viable.
After their release, ex-cons with mental health issues who meet the new Medicaid requirements will get access to needed medication or other treatments. Maybe they won’t end up arrested again.
“We are looking for the best ideas and where they are having the best results,” Gee said.
While many folks working in low-wage jobs benefit from new insurance coverage, Gee said the biggest impact could be on mental health.
We applaud the goal of reducing the costs to society of untreated mental illness. Expanding Medicaid might be a great help in that larger effort.