The Advocate. April 28, 2021.
Editorial: Medicaid expansion dollars can help our state budget, but tough decisions will come
Gov. John Bel Edwards stood on the football field inside Southern University’s A.W. Mumford Stadium before a small crowd of dozens in a stadium that holds about 28,000. Instead of waving to thousands of Jaguar football fans, Edwards stood behind a podium and talked to a few administration officials, legislative leaders and front-line health care workers.
The governor chose Southern to deliver his State of the State address, so there was room for social distancing of the audience.
It was an occasion that he could again boast of a real accomplishment: He reminded listeners that he expanded Medicaid in Louisiana five years ago, and we have seen results.
“Because of that decision, many more people have had access to a primary care physician and the ability to afford prescription medication in order to treat or control underlying conditions that make them more susceptible to COVID,” he said. “I know that we still have a lot of work to do in order to improve health outcomes, but I can’t imagine how many more people would have died this past year if not for Medicaid expansion.”
Though there may be ongoing questions about Medicaid in coming years, the expansion program is here to stay. About 600,000 are newly enrolled to receive benefits that include detection screenings and preventive care that prevent more costly health care, among other services.
As people lost jobs because of the pandemic, we saw how important Medicaid is as it became a safety net, preventing further economic falls and health deterioration. Because of the pandemic, the federal dollar match is higher than it is for traditional Medicaid, giving Louisiana and other states “savings” they can count on to bounce back from a year of financial struggle as tax revenue, income taxes and other revenue fell sharply. They might not say it publicly, but some states that chose not to pick the Medicaid expansion option are likely kicking themselves as they’ve struggled to plug big health care budget holes without federal financial support.
By taking advantage of the expansion, Commissioner of Administration Jay Dardenne said in an interview that Louisiana’s uninsured rate was lowered significantly. The pandemic-specific federal assistance provides the state with some “savings.” Last year, the state moved $258 million into this year’s 2021 budget. This year, based on recent state projections, the administration plans to move $366 million into next year’s budget. When asked what we will do when the pandemic funding is gone, Dardenne is honest: “We don’t know.”
We know. We elect our state legislators to wrestle with tough issues like this. Republican legislators who have expressed concerns about what happens are right to raise the question.
But we need to come out of this pandemic and work to recover the revenue that makes our state go. Once we see how quick and how strong a recovery we have, we will be better positioned to decide how to budget properly without an infusion of federal dollars to support Medicaid expansion.
END
Please read our comment policy before commenting.