Louisiana's Successful Medicaid Expansion Pressures Other States

It is hard to overstate the apparent success that Louisiana is having now that it finally has expanded Medicaid under Obamacare. Just since the beginning of June, over 200,000 people have enrolled and there is no doubt that the state will easily reach its goal of enrolling around 375,000 and saving the cash-strapped state close to $200 million.  Louisiana is the first of the Gulf Coast states to finally stop refusing the virtually free federal money to increase Medicaid coverage and it will put a little more pressure on other Gulf states, especially Alabama which is also considering expansion, to move forward.

What's even more remarkable about Louisiana's success is that the Republican legislature refused to fund any additional money to help kick-start the enrollment program; it has managed to register the 200,000 on a shoestring. State agencies used data from existing state health care systems and from the SNAP (Supplemental Nutrition Assistance Program) in order to contact and enroll eligible recipients.  With Louisiana's success at expanding Medicaid at virtually no additional cost while at the same time saving the state nearly $200 million, it is really hard to see how long the remaining holdouts can hold the line. Even in Kansas, there is a push finally move forward with expansion that would also aid the state's disastrous finances. And in Virginia, Governor Terry McAuliffe's attempt to expand Medicaid has been thwarted by the Republican legislature's tying the entire state budget to a ban on accepting federal funds to expand health care coverage in the state. McAuliffe has vetoed this provision as unconstitutional and it will be interesting to see where that case goes from here.

The common denominator in Louisiana's expansion and the attempt in Virginia is the election of a Democratic Governor in those states.  Without that, it is probable that neither state would be doing what they are today. But you do have to wonder, when people see the success that other states are having, how long Republicans can actually legislate against accepting federal funds to expand health care coverage. It's hard to see that's a winning long-term strategy.