Louisiana lawmakers are trying to tighten Medicaid cost estimates

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BATON ROUGE (AP) – Louisiana lawmakers are trying a new approach to determining how much the state will spend on Medicaid services each year, as the program has increased to more than a third of the state’s budget and added hundreds of thousands of people during the pandemic.

A Medicaid forecasting panel set up by lawmakers last year held its first meeting on Wednesday to create a new process for estimating spending needs for a program that provides health care to 1.9 million people – about 41% of Louisiana’s population.

The Louisiana Department of Health is currently doing its own economic modeling and then seeking funding from state legislators to match the forecast, which often overestimates how much money is needed to cover services. The Medicaid Estimating Conference will involve legislators, the Ministry of Health, the governor’s chief budget adviser and an external health economist, along with financial advisers to the Legislative Assembly.

“This program is too large to not have sufficient data,” said Senator Sharon Hewitt, the Slidell Republican whose bill created the conference.

Louisiana’s Medicaid program is estimated to spend $ 16 billion in the current fiscal year on health care, the vast majority of it federally funded and much of it through managed care companies. Hewitt said the state allocates $ 1.8 billion of the cost from its general fund.

However, estimating – and limiting – the price of the program can be difficult.

Many of the costs associated with Medicaid are beyond the control of the state. To obtain federal Medicaid funding, states are required to provide certain services through the program, and they are not allowed to force people out of the rolls if they received enhanced Medicaid funding offered due to the coronavirus pandemic, which Louisiana did.

Louisiana has added more than 300,000 people to its Medicaid rolls since March 2020, when the coronavirus outbreak began.

Daniel Cocran, the state’s Deputy Director of Medicaid, said about 70% of the growth was in the Medicaid expansion program. Democratic Gov. John Bel Edwards approved the enlargement, when he took office in 2016, to cover working-age adults who do not receive health insurance through their employers. Nearly 700,000 people are currently enrolled in Medicaid through this expansion.

Many of these enrollees would not continue to qualify for Medicaid coverage because they now earn too much money or stopped meeting other eligibility criteria. But Louisiana cannot kick them out of the rolls because of the austerity measures attached to the improved federal pandemic Medicaid funding.

These people can only be removed from Medicaid once the federal public health emergency is lifted, Cocran said. It is unclear when that will happen, and so federal rules describe a lengthy process of busting someone from the program even after that, he said.

President Joe Biden’s legislation to expand the social safety net awaiting Congress also has additional restrictions on removing people from Medicaid who would come into play if the measure goes into effect, health officials said.

All of this will be considered part of the new forecasting process, Hewitt said. She hopes to have the conference’s first forecast completed in December or January. The panel’s projections will be non-binding, but are expected to have a major impact on budgeting. The impartial legislative finance office hired a health economist as part of the effort.

Late. Gerald Boudreaux, a Lafayette Democrat at the conference, said he believes the new approach could help lawmakers determine the true cost of the Medicaid program, but he also warned that he does not want it to be used for to try to restrict access to health care.

“It’s very important to a lot of people, more people than some of us are aware of,” Boudreaux said.

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