Why Not Up the Mississippi?: Outtake from Cohen and DeLong, Concrete Economics

Must-Read: Tierney Sneed: Inside Louisiana's Blockbuster Medicaid Expansion Roll Out: "Louisiana's Medicaid expansion marked a major breakthrough for Obamacare...

...Now that the program has been open for enrollment for two weeks, the dramatic success the state has had in bringing residents into the program has attracted national attention. Since June 1... more than 201,000 people have enrolled. The state is well on track to meet its 375,000-enrollee goal, which will save Louisiana an estimated $184 million in the next year. Those numbers are even more remarkable given the obstacles facing the Edwards administration, namely the refusal of the GOP legislature to fund even one new employee to ease the transition to the expanded program....

Without any additional funding for the roll out--meaning no new state employees, no eligibility workers, nor any other new administrative tool to ensure that Louisianans were taking advantage of the expanded coverage--the state had to depend on the infrastructure of existing social service programs, whose participants were eligible for the Medicaid expansion. The tactic had the dual advantage of saving the state money while creating an application process that was minimally burdensome.... That creative approach... helped Louisiana achieve the numbers that it did. ‘Louisiana, through doing this, is definitely being a leader in trying to use these available resources to streamline and make enrollment efficient,’ Samantha Artiga, a Medicaid expert at the Kaiser Family Foundation, told TPM....

To pull together the program, the state sought out the assistance of non-governmental organizations like Robert Wood Johnson Foundation, Kaiser and Milbank. ‘As a former Robert Woods Johnson clinical scholar and someone who had been in academia, my mindset has always been focused on, ‘How do I get grants?’ Gee said. Making matters more difficult, the state was seeking out outside support after the wave of initial grant money--much of it going to early adopter states--had dried up. 'We missed out,’ Gee said, of the initial round of Center for Medicare & Medicaid innovation grants that went to states that expanded Medicaid right off the bat. ‘So here we are, needing it more than those places probably did without the ability to apply for those types of grants,’ she said. The state did find outside help, though mostly in the form of consulting and technical assistance...

http://talkingpointsmemo.com/dc/louisiana-medicaid-expansion

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