On his first full day in office, Democratic Gov. John Bel Edwards reversed course from his Republican predecessor Tuesday and started the process of expanding Louisiana's Medicaid program.
At a news conference surrounded by dozens of Medicaid expansion supporters, Edwards signed an executive order calling for the state Department of Health and Hospitals to make the administrative changes needed to begin offering the health insurance coverage to the working poor.
"This is the right thing to do. This is not even a close call," Edwards said.
Edwards' order came two days ahead of President Barack Obama's appearance in Baton Rouge, where he'll champion his federal health care overhaul that allows for the Medicaid expansion.
Former Gov. Republican Bobby Jindal, who was term-limited and left office this week, refused expansion, opposing it as too costly for the state and an inappropriate growth of government spending.
But Edwards, who was sworn in Monday, said the state should accept the billions of dollars in federal funding available to provide insurance coverage to Louisiana's working poor, calling it the right moral and financial choice.
The new governor said he wants to have government-funded health insurance cards in more people's hands by July 1.
His administration estimates that 300,000 more people, mainly the working poor, will be added to Louisiana's Medicaid program under the expansion, which covers adults making up to 138 percent of the federal poverty level — about $33,400 for a family of four.
Under the plan, Louisiana will join 30 other states that have undertaken Medicaid expansions, including several overseen by Republicans. Expansion efforts have been stymied in most Southern states amid GOP resistance.
Even as Edwards issued the executive order, several hurdles remain before people will receive Medicaid cards under the expansion.
Edwards' health secretary, Rebekah Gee, estimates her department will need to hire 248 new workers to handle the Medicaid patient enrollment and spend $2.8 million to pay for salaries, training and equipment. Gee said she has identified a way to get health care providers to pick up that cost this year, but it requires federal approval.
Questions also remain about whether Louisiana has enough doctors, specialists and other health care providers willing to see Medicaid patients to handle the influx of those who would eventually have the government-financed insurance coverage.
Also, the financing for the Medicaid expansion will need to be included in Louisiana's budget — which will require it to gain approval from a majority Republican state House and Senate.
And the state hasn't identified a way to pay for the state's cost-share that would be required for the Medicaid expansion in the future. Although the federal government covers the initial full cost of an expansion program, Louisiana's price tag will grow to 10 percent in later years.