Gov. John Bel Edwards signed the executive order to expand Louisiana’s Medicaid program on Tulane Medical School resident Sarah Candler’s birthday, Jan. 12. On Wednesday, Candler got to tell Edwards what it was like to inform her patients that they could sign up for the health care coverage.

“Many of them are newly eligible today, so that means patients I’ve wanted to prescribe certain medications to, I’ve wanted to get screening tests for and haven’t been able to do so because they didn’t have enough health insurance,” Candler said. “Today that changes.”

Candler said some of them were in tears at hearing the news. Many will receive health insurance for the first time under Medicaid expansion, Candler said, and are looking forward to the financial stability the government-sponsored insurance will provide.

Edwards was in New Orleans on Wednesday to mark the start of enrollment and note that, as of June 1, the Department of Health and Hospitals was already in communication with about 175,000 people the department believes will qualify for Medicaid expansion. Overall, DHH projects about 375,000 people, most of them working poor, will receive coverage as Louisiana becomes the first state in the Deep South to expand Medicaid eligibility.

The first person to enroll in Medicaid using DHH’s website, healthy.la.gov, signed up for Medicaid expansion at 8:05 a.m., said Ruth Kennedy, who’s leading the Medicaid expansion rollout for DHH. The department was already seeing a spike in new Medicaid applications by midday, Kennedy said.

In New Orleans, Edwards toured the new University Medical Center for the first time and said during a news conference that the $1.1 billion state-owned building is “truly worthy of the people of our state.” UMC, which is run by LCMC Health, is the largest of the nine privately operated hospitals that were formerly part of the LSU-run charity hospital system.

During a news conference at the hospital, Edwards addressed the politics of Medicaid expansion, saying, “This is right versus wrong, not right versus left.” He also urged people to sign up for Medicaid expansion if they haven’t already been contacted by DHH.

“At the end of the day … we’re going to improve health outcomes,” Edwards said. “We want a better quality of life for our people. We want them to be happier, healthier, more productive people.”

Leading the efforts of improving outcomes is Dr. Rebekah Gee, the DHH secretary. She joked that after Medicaid expansion begins July 1, people will no longer be able to use the excuse that they’re not healthy because they don’t have Medicaid.

“Health is now your responsibility,” Gee said. “Now you have to eat better, exercise and take better care of yourselves so we can be a healthier state.”

After Edwards spoke, he was asked whether he thought that politics could one day undermine any progress Louisiana makes if Medicaid expansion is successful. Edwards said that although he knows Republicans have worked to repeal the Affordable Care Act, which made Medicaid expansion an option for states, he doesn’t worry about what goes on in Washington.

But he did say that he believes that Medicaid expansion is the type of benefit that will be difficult to reverse.

“At some point, the momentum behind health care coverage catches a wind all its own,” Edwards said. “It will be very difficult for that political wind to change direction. Especially once we start showing people we are producing healthier citizens — a more productive citizenry.”

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John Bel Edwards talks Medicaid expansion in visit to University Medical Center