On March 26 - 28, 2012 the United States Supreme Court heard arguments in a case (NFIB v. Sebelius and Florida v. HHS) challenging certain provisions of the Patient Protection and Affordable Care Act (PPACA). In its majority opinion, the Court ruled that Congress had exceeded its power by threatening to withhold existing federal Medicaid funding to states that did not comply with the requirements to expand their programs in compliance with PPACA. With this ruling, each Governor and legislature is faced with a decision regarding the expansion of the state's Medicaid program. While Louisiana has elected not to expand its Medicaid program, this report outlines previous analyses of the impact of an expansion in Louisiana, the considerations and assumptions included, updates to these assumptions and continuing uncertainties.
It is important to reiterate that Louisiana does not believe that simply enrolling an individual in Medicaid guarantees their ability to access high quality health care services. State policy makers cannot afford to ignore the fact that expanding an inefficient 1960s-era entitlement program limits choice and fails to fully integrate its recipients into the broader health care system. While Louisiana has modernized its program to the extent allowed under federal regulations over the last year through the introduction of Bayou Health, there still exist many limitations to state-led innovation that can only be accomplished through a complex and cumbersome waiver process. Without fundamental reform, expanding Medicaid to millions of additional Americans is not the victory many envision. Louisiana continues to seek marketdriven solutions to strengthen its existing Medicaid program, regardless of any past or future considerations of expanding the program.
Below is the complete white paper.