Louisiana's health department has notified tens of thousands of Medicaid recipients that they could be booted from the program, after a newly used computer check found they earn too much money to receive the taxpayer-financed health coverage.
Gov. John Bel Edwards' administration didn't announce when it sent more than 37,000 letters to Medicaid enrollees around the state last week, but confirmed the mass mailing Thursday.
Nearly all those threatened with removal from the government health insurance coverage are non-elderly adults enrolled through the Medicaid expansion Edwards enacted in 2016 as allowed under the federal health law, according to the health department.
Health Secretary Rebekah Gee said the letters stem from a computer upgrade that does more frequent checks to ensure Medicaid enrollees don't make too much money to be in the program. The Edwards administration has touted the system as addressing Republican lawmakers' concerns the Medicaid program spent millions on people not eligible for the coverage.
"The governor and I want to make sure that only those who need Medicaid have Medicaid. This system will be much better able to determine who those people are," Gee said.
Anyone seeking to challenge the decision and retain their coverage needed to reply by this week. Medicaid coverage will end by March 31 for those who can't prove they meet the income criteria.
"If they do not get back to us, their cases will be closed," Gee said.
Gee said some people enrolled through Medicaid expansion likely have fluctuating or seasonal changes in employment that could keep them going in and out of the Medicaid program throughout the year, as their wages change. Others deemed ineligible for coverage, she said, hopefully got a job that came with insurance benefits.
But some bumped from the Medicaid rolls likely will become uninsured. The health department will be providing those people, Gee said, with information about how to seek coverage through the federal health insurance exchange.
The letters were expected to come up Friday in a legislative budget committee hearing. Several lawmakers said they had heard about the letters, but had been unable to get information from the Department of Health or copies of the correspondence by Thursday.
Edwards, a Democrat running for a second term, regularly touts the expansion program and the 500,000 people who newly received health insurance coverage because of it. In a speech Thursday, he credited expansion with cutting Louisiana's uninsured rate in half and giving thousands of people access to preventive services that have identified chronic illnesses.
Republicans say the expansion is too costly and has grown the Medicaid program at an unsustainable rate. They say the Edwards administration spent too much time trying to add people to the Medicaid rolls and too little time confirming people qualify.
The health department's upgraded computer system launched in November, as Legislative Auditor Daryl Purpera released a report that said Medicaid expansion may have spent as much as $85 million on ineligible enrollees.
Auditors suggested more double-checking of Medicaid recipients' income. The Edwards administration responded by announcing the improved computer system would do quarterly checks of eligibility, rather than the annual checks previously done, and would use more data for comparison to track a person's wages.
Under Medicaid expansion, adults ages 19 to 64 with incomes up to 138% of the federal poverty level — about $16,750 for a single adult or $28,680 for a family of three — are eligible for the coverage through one of Louisiana's Medicaid plans administered by private managed-care companies.
The federal government is paying most of the Medicaid expansion cost. Louisiana is paying a share that eventually increases to 10%. Lawmakers passed financing tools to help cover the state's costs, including a tax hike charged on health maintenance organizations.