The expansion of Medicaid, the federal-state health care program for poor and low-income Americans, has increased the amount of federal money going to the states. Louisiana is one of the major beneficiaries of those grants.
In fiscal 2015, the federal government spent an average of 31.9 percent of the money going to the 50 states, according to a report from the Pew Charitable Trusts. Louisiana received 42.2 percent of federal funding that year, tops in the nation, even though it had not yet expanded Medicaid. Mississippi was at 42.1 percent.
The federal shares were lowest in North Dakota (18.4 percent), Virginia (21.5 percent) and Hawaii (22.8 percent).
Federal dollars have made up a much larger percentage of Louisiana’s budget than most states since 2000. The highest up to 2015-16 came in 2009-10 when the federal government provided 48 percent of the state’s budget.
Federal spending has grown since Gov. John Bel Edwards expanded the Medicaid program immediately after he took office in 2016, a trend in the other 30 states that have also expanded the program.
Expansion of Medicaid wasn’t the only reason the federal government is spending more in the states. Pew said from 2000 to 2013 there were two economic downturns that caused people to lose jobs and their health insurance coverage and there was a gradual erosion of employer-sponsored health insurance.
Pew said Medicaid is most states’ biggest expense after K-12 education. In 2015, the states collectively spent $211.6 billion of their own resources on Medicaid, a $9 billion increase from 2014. Medicaid consumed 16.7 cents of each state-generated dollar — 4.5 cents more per dollar than in 2000.
Medicaid covers 74 million Americans and is the principal source of long-term care coverage, according to the Kaiser Family Foundation. Medicaid also provides significant financing for hospitals, community health centers, physicians, nursing homes and jobs in the health care sector, the foundation said.
Increasing costs of the Medicaid program are expected to result in changes to the program. Those who have benefited fear Medicaid expansion may be ended. States are concerned about the government establishing a per capita cap on how much is spent on the program. The next move is up to Congress.