Louisiana: State Estimates Over $100 Million in Net Savings in First Year of Medicaid Expansion

Governor John Bel Edwards' (D) administration estimates $155.3 million in State savings from Medicaid expansion in the first year of implementation, more than offsetting the estimated $51 million in costs, according to details released to media. The estimated savings would accrue from reduced uncompensated care payments, enhanced federal match for supplemental payments to safety net hospitals, shifting current Medicaid beneficiaries to the expansion group (which has a higher federal matching rate) and replacing general funds with Medicaid funds (for example, hospital costs for incarcerated individuals). These factors were excluded from former Governor Bobby Jindal's (R) administration's estimates of Medicaid expansion savings and costs. Governor Edwards announced the estimate in his "State of the State" address, at which time he also indicated a willingness to consider "personal responsibility" measures, such as co-payments, work referrals and healthy behavior incentives.

Oklahoma: 1115 Waiver Amendment Could Make Uninsured American Indians Eligible for Premium Assistance

The Oklahoma Health Care Authority (OHCA) submitted an 1115 waiver amendment to CMS requesting approval to establish the "Insure Oklahoma Sponsor's Choice Option," which would permit uninsured American Indians/Alaskan Natives up to 200% of the FPL to enroll in coverage sponsored by Indian Health Service Facilities, Tribal or Urban Indian Organizations (I/T/U). Medicaid would reimburse for the individuals' premium costs. OHCA estimates that more than a quarter of the State's uninsured are American Indians (80,000 individuals), and that the amendment would allow for 50,000 "potentially eligible" uninsured American Indians to gain coverage. The amendment, if approved, would be implemented January 1, 2017.