Medicaid “unwind” threatens coverage

Medicaid “unwind” threatens coverage

Louisiana’s health department plans to spend nearly $200 million over the next 15 months to help ensure that eligible people do not lose Medicaid coverage as the state re-starts reviewing income and other eligibility criteria for the first time in three years. More than 40% of Louisianans get coverage through the federal-state health care program, and enrollment surged during the pandemic as Congress gave states more money to pay claims and added safeguards to ensure that no one lost coverage. As those protections wane, state officials fear that up to 350,000 people could lose coverage. The Louisiana Illuminator’s Julie O’Donoghue reports: 

“No one’s district is not going to be affected by this,” Sen. Cameron Henry, R-Metairie, said at a budget hearing Tuesday. “Some might be affected more than others, but everyone’s going to get phone calls. … This is going to be a focal point for a while.” The federal government is ending COVID-19 protections in April that have kept millions of additional people across the country on Medicaid regardless of their income. It has given states financial incentives to let people stay on the public health insurance plan since 2020, but those benefits are coming to a close. States must now sort through who still qualifies for Medicaid coverage over the next 12 months. Individuals are supposed to be culled from the rolls only if they make too much money to remain eligible. Yet advocates fear low-income folks who still meet the requirements might also get booted from the program because they can’t produce the right paperwork on time.

State officials have started sending letters to verify contact information ahead of the massive disenrollment process. 


SNAP work requirements will increase hunger
More than 1 in 5 Louisiana residents received food assistance from the Supplemental Nutrition Assistance Program during the pandemic, according to a new report from the Louisiana Legislative Auditor. But Louisiana families who rely on this crucial assistance will receive an average of $164 less per month beginning in March as emergency allotments under SNAP return to pre-Covid amounts. The program is now in the crosshairs of conservative lawmakers who want to strip food benefits from anyone who isn’t working or can prove they are exempt from a work requirement. A new report from the Center on Budget and Policy Priorities explains that work requirements don’t actually increase employment: 

Independent studies have repeatedly shown that SNAP’s work-or-lose-benefits time limit does not increase employment or earnings. It just cuts people off from the food assistance they need to buy groceries. … Before the pandemic, nearly three-quarters of adults participating in SNAP in a typical month worked either that month or within a year of that month of participation. At almost 90 percent of households, the rate was even higher among households with children and at least one working-age adult.

The reduction in federal food assistance and efforts to further limit its reach come at a time when prices on groceries and other basic necessities remain high


A “true transition” for energy workers
America’s transition from fossil fuels to a clean-energy economy is coming quickly to Louisiana, with a spate of offshore wind projects poised to take off in the next few years. That will have a profound impact on the state’s workforce, especially oilfield workers who have already seen their numbers dwindle. Leo Lindner and Megan Milliken Biven of True Transition, in a guest column for The Advocate, say that workers need to have a greater voice in the process. 

This transition to new energy could be a bright opportunity for energy workers, but if they aren’t at the table, they’ll only get the scraps left over from the feast. Oil workers sacrifice a large part of their lives to this work — sometimes, all of it. They shouldn’t sit by and watch themselves treated like coal miners who got a pat on the back and were told, “learn to code.” We owe workers a clear path to a decent life. A true transition doesn’t just mean switching to clean energy, but shifting to a country that treats the people who create the wealth like the assets they truly are. Even if we can only get close, that kind of transition will be true enough.


The importance of postpartum Medicaid coverage
America’ maternal mortality rate, the highest among developed countries, increased during the pandemic. The mortality rate for Black mothers was higher than for their white counterparts. But tucked inside the federal American Rescue Plan Act was a little-noticed provision that allowed states to offer a full year of postpartum Medicaid coverage for new moms. States with near-total abortion bans, like Louisiana, typically have higher maternal mortality rates. Stateline’s Elisha Brown explains how ARPA’s postpartum provision is especially important for these states in a post-Dobbs world. 

“Increasing the number of perinatal health care workers who can look like the people they’re serving is definitely a solution so that they can improve maternal health outcomes because they can improve culturally congruent care,” said Laneceya Russ, the Louisiana-based executive director of March for Moms, a national maternal health advocacy group. For Wallace, the Tulane epidemiologist, “it’s been disturbing to watch the closure of birthing centers and other maternity care opportunities in rural places across the country.” Repealing collaborative practice agreements between physicians and assisting health care providers, such as nurse practitioners, could help expand midwifery care and address staff shortages in maternity care, Wallace said.

Last April, Louisiana became the first state to take advantage of extended postpartum coverage, which is welcome news in a state that has the second-highest infant mortality rate in the country. Louisiana also provides 12-month continuous eligibility for children in Medicaid or CHIP.


Number of the Day
8% – Percentage of Louisiana’s population that is at risk of losing health coverage. Almost 2 million Louisianans—more than 40% of the state’s population—will have their Medicaid eligibility reviewed as pandemic-era health benefits expire. (Source: Louisiana Department of Health via The Advocate)