OPELOUSAS, La.—Joshua Guillory, 32, dropped his Obamacare health plan in January after losing his oil plant job. He couldn’t afford the premiums any longer.

He still needed treatment, though, for recently diagnosed sleep apnea and the pain from long-standing nerve damage in his leg. He also suffers from obesity and high blood pressure.

After his father told him that he might qualify for Medicaid under Louisiana’s newly expanded program, he met with enrollment counselor Tama Stears at the Southwest Louisiana Primary Health Care Center, a federally qualified community health center here. They worked with an agent at HealthCare.Gov and completed his application for Medicaid coverage, which starts July 1.

“That’s a blessing,” Guillory said.

He’s one of 375,000 low-income adults expected to sign up under the state’s expansion, which was ordered in January by new Democratic Gov. John Bel Edwards, who campaigned hard on the Medicaid expansion issue. The previous governor, Republican Bobby Jindal, had blocked expansion.

Louisiana is the 31st state—and the first in the Deep South—to extend Medicaid coverage under the Affordable Care Act to adults with incomes up to 138% of poverty. The expansion, fully supported by the federal government through this year, will be partly paid for in future years by fees levied on Louisiana hospitals, estimated at $27 million in the first year and $120 million by year five.

Edwards predicted four or five other Southern states will follow Louisiana in expanding Medicaid if Hillary Clinton and the Democrats win the November elections. “If it becomes obvious the Affordable Care Act won’t be repealed, a number of states will opt into the expansion fairly quickly,” he told a group of reporters in Baton Rouge last week.

Stears said some of her clients have a hard time believing the expansion is actually happening. “A lot of people ask, ‘Is it real Medicaid? Will it cover the services I need?’ ”

The Edwards administration has succeeded in getting the message out with remarkable speed and effectiveness through hospitals, clinics, health plans and schools. The governor announced last week that more than 200,000 people have signed up since enrollment started June 1.

Expanding Medicaid, he said, was “the easiest big decision I’ll ever make” given the state’s large uninsured population, poor health status, budget problems, and the burden of uncompensated care on healthcare providers. He overcame the resistance of the Republican-controlled Legislature by stressing that the Medicaid expansion was funded by dollars Louisiana taxpayers already were paying and that were going to other states. “That resonated with conservatives,” he said.

Medicaid expansion hits Deep South
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