Louisiana lost 160,000 from Medicaid Insurance

According to state data, Louisiana has removed more than 160,000 people from its Medicaid rolls since federal protections that kept coverage in place during the pandemic ended in April. Of those, at least 53,079 people (about 33%) are children.

Medicaid is a public health insurance program primarily for low-income people. It also includes some elderly and disabled people. At its peak earlier this year, Louisiana’s Medicaid enrollment skyrocketed to more than two million, about 45% of the population. That’s about 450,000 more than the state’s usual level before the pause.

States have begun what is being called a nationwide “unbundling” process. To date, 3 in 4 Louisiana Medicaid patients have lost coverage due to technical “procedural reasons” issues such as paperwork, incomplete renewal packets or outdated contact information. But many were able to re-register.

“Some people can reapply and continue participating and that’s not a problem,” said Courtney Foster, a Medicaid policy advocate for the Louisiana Budget Project. “But we know when there are disruptions in coverage, it can impact whether people go to the doctor because of the confusion around whether they have to pay.”

In children, advocates say, it can lead to educational and developmental delays that are more difficult and costly to address if they are allowed to fester longer. Seven out of ten children in Louisiana were covered by Medicaid earlier this year. Only New Mexico has a higher percentage of children dependent on Medicaid for health care.

Susan Nelson, executive director of the Louisiana Partnership for Children and Families, a nonprofit advocacy organization, said children make up more than 800,000 people enrolled in Louisiana’s Medicaid programs.

“Any of those declines are problematic, and we had actually been watching child insurance rates decline for several years before that,” she said.

Children without health insurance may not be able to get regular doctor appointments and vaccinations. That leads to a loss of screening processes like hearing, vision and balance that determine when children are falling behind on developmental milestones, Nelson said.

“What we’re going to see is kids who later have severe academic delays that are much more difficult to overcome in third, fourth, fifth grade,” Nelson said.

Some states, such as Maine, provide continuous coverage for children 6 years of age and younger if they qualify for Medicaid at any time. Louisiana covers children for 12 months after they become eligible, after which they must re-enroll. For parents with multiple children enrolled at different times, that can be taxing, Nelson said.

Children typically account for a small portion of Medicaid spending. In 2019, CHIP, the program that pays children when their parents earn too much to qualify for Medicaid, accounted for 3% of the $12.4 billion budget.

The federal government pays a large portion of Louisiana’s Medicaid costs, typically between 70-74%. Next year, for every dollar spent, Louisiana will receive about $1.67 from the federal government.

Louisiana has done more than most states to automatically renew Medicaid beneficiaries, using the state’s wage database to check eligibility before firing someone. According to a report from the Kaiser Family Foundation, about 80% of state renewals come through this “ex-parte” process, compared to the national average of 56%.

Of the nearly 162,000 people who lost Medicaid in Louisiana as of the end of August, about 28,300 have re-enrolled, a process known as “churning.” Among them are about 15,200 children.

State representatives reaching out to families have experienced address changes and unanswered phone calls. Many Louisiana residents have moved in the past three years due to changes in financial status or after several hurricanes hit the state. Rural residents are especially difficult to reach, said Erica French, Southeast Louisiana Community Outreach Coordinator. That leads to a large number of people giving up due to procedural reasons.

The state has a 37 percent disenrollment rate, which is about average for the number of residents dropped from the program. In comparison, states like Texas, Idaho and Montana disenrolled more than 60% of their Medicaid recipients.

“It’s great that Louisiana is doing better than other states,” Foster said. “We can still do better.”

The state did not respond to questions about how reenrollment affected the overall movement of children receiving Medicaid.

People interested in renewing their Medicaid coverage can call 1-888-342-6207 or visit swlahec.org/navigators for assistance.

(c)2023 The Times-Picayune | New Orleans supporter. Distributed by Tribune Content Agency, LLC.

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