Louisiana Gov.-elect John Bel Edwards has set an ambitious timeline for a Medicaid expansion, saying he wants to have government-funded health insurance cards in thousands more people's hands by July 1.
To make that happen, his new healthcare leader said Louisiana will have to hire nearly 250 new health department workers to handle the enrollment and find the dollars to pay them, in a state saddled with deep budget problems.
Incoming Health and Hospitals Secretary Rebekah Gee also said the new administration will have to work with healthcare providers to ensure they're willing to see the patients who will have those new Medicaid insurance cards.
And that's assuming the Republican-led Legislature doesn't try to throw up any roadblocks seeking to slow down an expansion effort.
Edwards, a Democrat who takes office Monday, said he would issue an executive order "within 24 hours from being sworn in" that starts the work required to expand Medicaid as allowed under the federal healthcare law. Health coverage for the people who would be eligible for the insurance under the expansion, he said, would begin July 1.
"There is not a challenge there that we won't meet and overcome, because it's too important for the state," Edwards said Tuesday as he announced Gee as his health secretary.
Gee said she was confident the expanded Medicaid coverage could begin in six months. But she added: "I can't promise you that every single person with a Medicaid card can get seen that day."
The incoming health secretary estimated that about 300,000 people, mainly the working poor, would be enrolled for Medicaid under an expansion, which covers adults making up to 138% of the federal poverty level — about $33,400 for a family of four. However, Gee said she doesn't think all of those people would be signed up in time for the July 1 start date.
Term-limited Gov. Bobby Jindal refused expansion, opposing it as too costly for the state and as an inappropriate growth of government spending. But Edwards wants to accept the billions of dollars in federal funding available to provide insurance coverage to Louisiana's working poor, calling it both a proper moral and financial choice for the state.
Although the federal government would cover the initial full cost of an expansion program, the state in later years would need to pay for 10% of the initiative. Louisiana doesn't have a plan for fully paying that cost.
There are also more immediate, short-term costs.
Gee said the Jindal administration's health department staff estimated the agency would need to hire around 248 people to determine people's eligibility for the expanded coverage and to sign up enrollees. The cost for salaries, training and equipment is expected to be $2 million.
The Edwards administration hasn't said how it will pay for that as Louisiana grapples with hefty budget shortfalls.
Handing out hundreds of thousands of new government-funded insurance cards also is expected to be a large demand on the state's health system. Many doctors won't see Medicaid patients, saying payment rates are too low and government paperwork too cumbersome.
"One of the big areas of focus is making the providers want to see the Medicaid patients, helping them want to see them by assisting them with better customer service, better communication, simplifying whenever possible how they're able to deliver services for this population," Gee said.
