BATON ROUGE, La. (AP) — On his first full day in office, Democratic Gov. John Bel Edwards reversed course from his Republican predecessor Tuesday and started the process of expanding Louisiana's Medicaid program.
Surrounded by Medicaid expansion supporters at a news conference, Edwards signed an executive order calling for the state Department of Health and Hospitals to make the administrative changes needed to begin offering the health insurance coverage to the working poor. It was his first executive order as governor.
"This is the right thing to do. This is not even a close call," Edwards said.
Edwards' order came two days ahead of President Barack Obama's public appearance in Baton Rouge, where he'll champion his federal health care overhaul that allows for the Medicaid expansion.
Former Gov. Republican Bobby Jindal, who was term-limited and left office this week, refused expansion, opposing it as too costly for the state and an inappropriate growth of government spending.
But Edwards, who was sworn in Monday, said the state should accept the billions of dollars in federal funding available to provide the insurance coverage, calling it the right moral and financial choice.
The new governor said he wants to have government-funded health insurance cards in more people's hands by July 1. It wasn't immediately clear whether the state's majority-Republican Legislature will try to create roadblocks to that goal.
"We fought it for four years. I think everybody will be checking their philosophical core, and we'll be talking about that," said Rep. Lance Harris, chairman of the House Republican delegation, saying the group hadn't decided whether to fight Edwards' plan.
The Edwards administration estimates that 300,000 more people, mainly the working poor, will be added to Louisiana's Medicaid program under the expansion, which covers adults making up to 138 percent of the federal poverty level — about $33,400 for a family of four.
Under the plan, Louisiana will join 30 other states that have undertaken Medicaid expansions, including several overseen by Republicans. Few are in the South, where expansion efforts have been stymied amid GOP resistance.
"We do not want to continue to send our federal tax dollars to Washington to then be given to 30 other states to help their people who need access to quality health care while ours go without," Edwards said.
Even as Edwards issued the executive order, several hurdles remain before people will receive Medicaid cards under the expansion.
Edwards' health secretary, Rebekah Gee, estimates her department will need to hire 248 new workers to handle the Medicaid patient enrollment and spend $2.8 million to pay for salaries, training and equipment. Gee said she has identified a way to get health care providers to pick up that cost this year, but it requires federal approval.
Questions also remain about whether Louisiana has enough doctors, specialists and other health care providers willing to see Medicaid patients to handle the influx of those who would eventually have the government-financed insurance coverage.
Also, the Medicaid expansion financing will need to be included in Louisiana's budget — which will require it to gain approval from a majority Republican state House and Senate.
And the state hasn't identified a way to pay for its cost-share in the future. Although the federal government covers the initial full cost of a Medicaid expansion program, Louisiana's price tag will grow to 10 percent in later years.
Despite those outstanding questions, praise poured in from health advocacy groups and Democratic officials.
"This decision will give our residents access to preventive care, reduce the need for expansive emergency room care and provide Louisianans peace of mind that if they get sick they will get the health care they deserve without going bankrupt," Denise Bottcher, Louisiana state director of AARP, said in a statement.
Criticism came from conservative organizations and some business groups, raising cost concerns for both the federal and state governments.
"I understand how tempting it must be to take billions of dollars from Washington, but, eventually, the cost of the program is going to shift from the federal government to the people of Louisiana," Dawn Starns, state director of the National Federation of Independent Business, said in a statement.