BY: JULIE O'DONOGHUE
Louisiana removed 50,600 people from government-funded Medicaid health insurance over the last few weeks as part of the government program’s massive disenrollment process nationwide. But the decision to drop all those people may not be permanent.
Those kicked out of Medicaid likely include residents still eligible for the benefits, said Kevin Litten, spokesman for the Louisiana Department of Health. Many of them — potentially thousands — will sign up for the program again once they discover they’ve been dropped.
Nearly three-quarters of this group only lost their Medicaid benefits for “procedural reasons,” such as failing to respond to prompts from the state health department to renew their enrollment. A smaller cohort — approximately 13,000 people — was kicked off because they do not meet the income eligibility requirements, according to data provided by the state. The federal government directed Louisiana and other states to start culling Medicaid rolls in the spring when the federal public health emergency for COVID-19 ended. It’s an enormous undertaking in Louisiana, a poor state where approximately 2 million people, 44% of Louisiana residents, are enrolled in Medicaid. This year, nearly half of the state’s $44 billion annual budget will be spent on health care services.
The federal government provides the bulk of the funding for state Medicaid programs, covering anywhere from a third of the cost of coverage for adults with disabilities to nearly the entire bill for children from low-income families. States put up the rest of the money.
Louisiana’s Medicaid program has ballooned since March of 2020 when Congress started offering financial incentives to states that paused their disenrollment process. Over three years, the program grew by nearly 450,000 people, a population larger than the city New Orleans.
State health officials don’t expect to see as many people taken off the Medicaid rolls through the disenrollment process, however. Initial estimates given this spring anticipated a total of 355,000 people would initially lose coverage, with over 100,000 then being added back or newly joining the program, resulting in a net drop of 222,400 by next year. This equates to a little less than the population of Caddo Parish, where Shreveport is located.
In Louisiana, the removals will take place every month over the next year. The federal government requires states to try to reach Medicaid participant multiple times before taking them out of the program. Louisiana started contacting enrollees through a widespread letter campaign earlier this year.
In total, the state has budgeted $195.8 million — the bulk of it federal funding — to spend on the Medicaid disenrollment process. Approximately $66 million will go to hospitals, pharmacies and nonprofits to help their patients and clients stay enrolled in the program if they qualify. Other money is going to advertising, Medicaid program technology upgrades and overtime for state workers in the Medicaid department.
Advocates still have concerns it won’t be enough to keep people from falling through the cracks. Many people who are poor experienced upheaval during the COVID-19 pandemic. Multiple hurricanes also hit Louisiana between 2020 and 2023, causing people to move.
“That has always been our concern,” said Jan Moller, with the Louisiana Budget Project, a left-leaning think tank that studies policy affecting low-income families. “People live chaotic lives, and many people’s lives have changed dramatically since the pandemic's beginning.”
But conservatives in the Louisiana Legislature suggested the health department isn’t working fast enough to trim the Medicaid rolls and needs to cut its overall budget. Louisiana is on a slower timeline for disenrollment and started the process several weeks after neighboring states started dropping people.
“Why do you need more money if you are going to serve fewer people?” asked House Rep. Tony Bacala, R-Gonzales.
Texas has booted 500,000 people from Medicaid since April, though state workers said as many as 80,000 people were erroneously removed from the rolls, according to the Texas Tribune. Mississippi has dropped 29,000 people from its program, according to Mississippi Today, and Arkansas has disenrolled 112,000 people. The concern is that many of the people who might be losing coverage across the country are children from families who missed a deadline to file the required paperwork. Louisiana has not provided details about its disenrollment figures yet that would indicate whether children are losing coverage.