Louisiana Medicaid Expansion and Access to Care
SCHOOL OF PUBLIC HEALTH AND TROPICAL MEDICINE Department of Health Policy and Management Louisiana Medicaid Expansion and Access to Care Prepared for the Louisiana Department of Health Prepared by: Mark L. Diana, PhD Kevin Callison, PhD Charlotte Cunliffe, PhD Charles Stoecker, PhD Lizheng Shi, PhD Mollye Demosthenidy, JD Janna Wisniewski, PhD July 2019 This study was funded by a grant from the Louisiana Department of Health through the LSU Center for Healthcare Value & Equity. Executive Summary Medicaid Expansion and Access to Care (2013 - 2018) Background Currently 37 states have expanded Medicaid coverage under the Affordable Care Act (ACA), including Louisiana, which extended coverage for all adults earning up to 138% of the federal poverty level (FPL) on July 1, 2016 (Henry J. Kaiser Family Foundation, 2019). As of December 2018, more than 475,000 individuals have enrolled in Medicaid expansion in Louisiana and, as a result, the number of uninsured in the state has fallen by more than 50% (Barnes, Henderson, Terrell, & Virgets, 2018). State ACA Medicaid expansions have been associated with increased insurance coverage, improved hospital financial performance, and improved economic outcomes.1 For those gaining coverage under expansion, studies have reported improved access to care, increased utilization, and improved health outcomes.2 While certain negative consequences of Medicaid expansion have been documented, such as increased wait times for care (Miller & Wherry, 2017), the evidence overwhelmingly supports the view that Medicaid expansion has improved access to care in adopting states. According to a recent review of Medicaid expansion studies, “Sixty-one percent [of studies] reported a significant effect of Medicaid expansion consistent with the goals of the ACA.
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