Louisiana will enroll the first of thousands of newly eligible residents into Medicaid on Wednesday, marking a “tipping point” in President Obama’s push to expand the government-run insurance program under his signature health care law.

After years of GOP resistance, Democratic Gov. John Bel Edwards took office this year and pledged to cover an estimated 375,000 more adults. They will start to sign up this week for coverage that starts July 1.

The Affordable Care Act initially required states to extend Medicaid to those making up to 138 percent of the federal poverty level, but the Supreme Court made it optional in 2012.

With Louisiana opting in, more than half of the uninsured who stand to benefit from the provision now live in states that chose to expand.

“Thanks to the leadership of Governor Edwards alongside the hard work of federal, state, and local partners, starting tomorrow, hundreds of thousands of Louisianans will be able to join the 20 million Americans who have obtained quality, affordable health coverage because of the Affordable Care Act,” HHS Secretary Sylvia Mathews Burwell said. “This is another step in our country’s march toward a health care system that works better for everyone.”

Louisiana will be the first state to use data from its food-stamp program, or Supplemental Nutrition Assistance Program (SNAP), to determine eligibility and enroll people in Medicaid, so residents don’t have to re-submit their personal data to qualify for each program.

As written, Obamacare expanded Medicaid in every state so that people living in poverty could be covered, while those with slightly higher incomes would leverage income-based tax credits to buy private plans on web-based insurance exchanges in each state.

But 19 states have refused to expand, saying it would bloat a failed government program and bust their budgets down the road.

Despite heavy lobbying from the administration, large states like Texas and Florida have balked at expansion.

Several other GOP-led states have opted in, despite their opposition to the underlying law. That’s because the federal government is picking up 100 percent of the costs for the newly eligible population in 2014-2016, before scaling back its contribution to 90 percent by 2020 and beyond.

Holdout states say expansion is already costing too much in states that opted in, and that it will begin to extract real pain when the federal share ebbs. Still others say Washington can’t be trusted to hold up its end of the bargain in perpetuity.

To sweeten the deal, Mr. Obama wants to let states expand beyond 2016 and still receive a full three years of the 100-percent contribution.

The GOP-led Congress has resisted the idea, however, and is pursuing a plan to repeal and replace Obamacare in 2017 if they can maintain their Capitol Hill majorities and get Republican presidential nominee Donald Trump into the White House.

Louisiana kicks off Medicaid expansion, marking ‘tipping point’ under Obamacare
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