Reversing years of gains, the share of Louisianans without health insurance, increased to 8.9% in 2019 from a historic low of 8% in 2018, according to the latest federal data released this week. This loss in coverage translates to more than 400,000 Louisianans lacking basic health insurance going into the Covid-19 pandemic at the start of 2020.
The increase in Louisiana’s uninsured rate mirrors a trend seen across the country, where the percentage of the population without health insurance has risen steadily since hitting an historic low of 8.6% in 2016. The national uninsured rate climbed to 9.2% in 2019 from 8.9% in 2018, a statistically significant increase according to the U.S. Census Bureau.
These losses in coverage are harmful to communities. Over the past several years, the Trump administration has enacted policies that have eroded coverage gains. As of 2019, such policies include the repeal of the Affordable Care Act (ACA) individual mandate, support of policies that erect barriers to Medicaid enrollment at the state level, cuts to outreach and enrollment support for the ACA marketplace, and a hostile stance toward immigrant families that has sown confusion and likely caused many in this already vulnerable population to forgo health care and health insurance.
In addition to harmful policies, the Covid-19 pandemic has surely increased the number of uninsured as an unprecedented number of workers – disproportionately black and brown – have lost their jobs and accompanying employer-sponsored health insurance, which often covers both the worker and their families. The uninsured rates reported here are based on survey results from 2019 and do not capture the radically different landscape of 2020.
Despite the tremendous gains it has brought in health care access, the Affordable Care Act is again under threat by a reckless lawsuit that seeks to strike the law. Louisiana Attorney General Jeff Landry is among those who have joined the suit, which is scheduled to be heard by the U.S. Supreme Court on Nov. 10.
States that expanded Medicaid continue to see greater coverage in health insurance.
The ACA has led to historic gains in health insurance coverage, with the biggest gains happening in states like Louisiana that expanded Medicaid eligibility. Unlike Louisiana, neighboring states have continued to struggle with high uninsured rates. In 2019, both Texas and Mississippi saw statistically significant increases in uninsured rates while Alabama saw a slight – statistically insignificant – decrease.
Medicaid continues to be a critical component of Louisiana’s health care system and provides coverage to nearly 1 in 3 Louisanans. Since expanding eligibility for the program under the ACA in 2016, more than 530,000 low-income adults have gained coverage. Because of expansion, more people are receiving preventative and life-saving care, including: more than 400,000 people who have seen a doctor within the year, nearly 90,000 women who have been screened for breast cancer, more than 50,000 who have been screened for colon cancer, and over 115,000 who have received mental health services.
Medicaid expansion is also good for the state economy. It has brought 14,000 local jobs and $1.7 billion a year in federal dollars into Louisiana’s private health care industry – money that supports physicians, nurses, pharmacies and health insurance professionals employed by the private Managed Care Organizations (MCOs) that administer the program.
Medicaid provides vital health insurance coverage to Louisiana front line and essential workers amid Covid-19.
More than ever, Medicaid is helping those who help us. Health care workers, bus drivers, grocery store clerks and food production line workers who aren’t covered through employer-sponsored health insurance rely on Medicaid to see a doctor when they are sick and receive ongoing care. During the Covid-19 pandemic, this coverage has been a lifeline for front-line workers.
The rise in the uninsured rate should serve as a wake up call to Louisianans, especially as the nation combats the Covid-19 public health emergency. Now is the time to invest in a strong health care system and to strengthen the policies and protections that have led to historically low uninsured rates not further erode hard won gains.
Fortunately, Louisiana expanded Medicaid prior to the Covid-19 pandemic creating a lifeline for newly unemployed workers and families. Congress should heed the warning in rising uninsured rates and enact legislation that provides much needed relief to workers and families in distress, including reinvesting in health care and health insurance.