1. Medicaid Expansion is Right Choice for Louisiana
Steve Spires
Louisiana Budget Project

2. About Louisiana Budget Project
Provides independent, nonpartisan research and
analysis of public policy issues and their impact
on low- and moderate-income Louisiana families
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3. Health reform is needed
1 in 4 non-elderly adults in Louisiana is uninsured
LA has some of the strictest Medicaid eligibility for adults in the nation, income limit around 15 percent FPL —or less than $3,000 a year for a family of 3
Employer-sponsored insurance coverage has been declining for years
Only 5 percent of children are uninsured due to success of LaCHIP (we know that Medicaid expansions in LA WORK!)

4. Medicaid expansion eligibility:
$14,850 for an individual
$25,390 for a family of three

5. Key Findings from Our Research
Of estimated 330,000 uninsured people who would qualify for Medicaid expansion, the majority—200,000—are working
Major coverage gains in important economic sectors: construction, entertainment/tourism and retail
Other results: major gains among health care and child care employees

6. Where Do Uninsured Louisianans Who Could Gain Medicaid Coverage Work?
Medicaid Expansion is Critical for Low-Income Working People
Where Do Uninsured Louisianans Who Could Gain Medicaid Coverage Work?
Restaurants and Food Service
33,900
Construction
24,300
Grocery Stores
8,400
Nursing Homes
6,300
Hotels and Motels
6,100
Landscaping Services
6,000
Professional Building Services
4,450
Elementary and Secondary Schools
4,400
Home Health Care Providers
4,100
Hospitals
4,050

7. Medicaid Expansion is Critical for Low-Income Working People
Occupations w/ Average Wages That Could Make a Family Eligible for Medicaid Expansion (Source: Louisiana Workforce Commission)
Occupation
Avg. Hourly Wage
Annual Full Time Wage
Child Care Worker
$9.00
$18,730
Construction Laborer
$12.80
$26,600
Hairdresser
$12.00
$24,920
Home Health Aide
$9.30
$19,380
Hotel Desk Clerk
$9.40
$19,530
Landscaper
$10.85
$22,570
Maid/Housekeeper
$8.80
$18,340
Restaurant Cook
$10.60
$22,060
Retail Salesperson
$11.10
$23,110
Waiter/Waitress
$9.10
$18,990

8. Expansion = More Health Security
More than 50,000 uninsured Louisianans who would be expansion eligible were working in the last few years— many are unemployed due to the still weak economy.

9. Medicaid expansion will benefit Louisianans in every parish
Shreveport
Monroe
Alexandria
Baton Rouge
Lake Charles
New Orleans
Lafayette

10. Medicaid Expansion is a GOOD DEAL!
Federal government will pay 100% of the cost for the first three years
State will slowly chip in after that, but never have to pay more than 10% of the cost
By comparison, today the feds pay for around 65% of Louisiana’s Medicaid program, with the state responsible for 35%

11. State cost has been exaggerated
Jindal administration is often quoted saying expansion will cost $3.7 billion over 10 years
More credible estimates closer to $1 billion
True cost is likely lower, as there will be offsetting savings elsewhere due to reform
In return, Louisiana will receive $15.7 billion in new federal money through 2022

12. We are already paying
Louisiana already spends millions each year on health care services for the uninsured. So do private and non-profit providers
Families and businesses with private insurance pay higher premiums due to “cost shifting”
Reform will improve the health care system and result in some savings that can be used to help cover the cost of Medicaid expansion

13. What is a Health Insurance Exchange?
Online marketplace where consumers can comparison shop for insurance
Tax credits available for families and some small businesses
Federal government will run Louisiana’s exchange

14. More Choice and Affordability
Exchange could benefit more than 300,000 Louisianans
Current individual and small group markets are often unaffordable—greater “purchasing power” will bring down high premium costs
Premium tax credits could total more than $385 million in the first year alone

15. Positive Health Impacts
Louisiana ranks near the bottom in national health rankings
Medicaid expansion would improve access to care, reduce financial stress on families and result in better overall well-being
New research shows that Medicaid expansions even reduce state mortality rates

16. Positive Economic Impacts
Medicaid currently supports an estimated 50,000 health-care jobs and thousands more “indirect” jobs across the state
Influx of new federal health care dollars will stimulate state economy
Expansion means more competition for health care services

17. Direct Benefits for Employers
Healthier workforce is a more productive workforce
Access to insurance results in fewer missed days of work and better health management for employees
Less “job lock” means more efficient labor market and better employees

18. We can’t afford to NOT expand Medicaid
The need for Medicaid expansion is clear. Without expansion:
Poor health outcomes will continue to affect our workforce and diminish productivity
Financial pressure on the state and health care providers will increase
Continued “cost shifting” will affect those with private insurance

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