Bloomberg Businessweek (Asia)

A regulatory sandbox for Wall Street • Louisiana’s smart Medicaid idea

The Bayou State is increasing the uptake rate for Medicaid via food stamp eligibilit­y


Six years after Obamacare became law, about 30 million Americans still lack health insurance. Louisiana has found a trick to get a great number of them to sign up for Medicaid.

The policy is based on a simple coincidenc­e: Medicaid and the federal food stamp program have almost the same income threshold, at least in the 31 states that have expanded their Medicaid programs under the Affordable Care Act. The Bayou State has decided to automatica­lly check to see whether the residents who receive food stamps also qualify for Medicaid— and if so, to reach out and sign them up. This approach will at once lower the state’s uninsured rate (one of the highest in the country) and cut Medicaid’s administra­tive costs.

The strategy seems so obvious, it’s a wonder no other state has made it policy. Nationwide, some 8.8 million people who are eligible for Medicaid haven’t enrolled. To put that in perspectiv­e, it’s more than the number in any of these categories: people who are eligible for subsidized Obamacare insurance plans but haven’t signed up; people who lack insurance because their states have refused to cooperate in the Medicaid expansion; or people who can’t get insurance because they’re in the country illegally.

Increasing the uptake rate for Medicaid is the single most promising way to reduce the number of uninsured Americans— and it requires no action by Congress. Louisiana has already identified 105,000 potential enrollees. It’s true that greater enrollment will increase Medicaid spending. But it will eliminate much of the public cost that arises when uninsured residents seek expensive care in emergency rooms.

Louisiana, whose budget shortfall is among the most severe in the country, demonstrat­es that enrolling more people in Medicaid doesn’t undermine fiscal prudence or good government. That’s a message other states should hear. <BW>

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