As Louisiana Gov. Refuses To Expand Medicaid, New Orleans Pursues Its Own Solutions

City officials in New Orleans are taking matters into their own hands while Gov. Bobby Jindal (R-LA) continues to resist implementing an Obamacare provision that would expand the Medicaid program in his state to cover additional low-income Louisianans.

Despite the fact that about 20 percent of Louisiana residents lack health insurance — one of the highest rates of uninsurance in the nation, behind just Texas and Nevada — Jindal refuses to accept federal funds under Obamacare’s proposed Medicaid expansion to address this coverage gap. In an effort to provide low-income residents with affordable health coverage even without the federal expansion of the Medicaid program, officials in New Orleans are working to circumvent Jindal’s decision:

Jindal said the Affordable Care Act, including the Medicaid expansion, is too costly and he is one of nine GOP governors who declined to implement the Medicaid expansion. […] But New Orleans officials said they are encouraged by a Medicaid waiver that has allowed the city to provide preventative care at no charge to uninsured low-income residents and at sliding scale, based on income, for others. That waiver expires in 2014, and the city hopes it will be able to continue to provide universal coverage through expansion of Medicaid envisioned by the health-care overhaul law, Health Commissioner Karen DeSalvo said.

“Should the governor not expand Medicaid as allowed through the Affordable Care Act, our administration is working with the (federal) Department of Health and Human Services on looking into some options to provide universal coverage for our residents,” DeSalvo said.

Louisiana Department of Health and Hospital Secretary Bruce Greenstein didn’t explicitly say that his agency would reject the proposed Medicaid expansion in New Orleans, but he did note that New Orleans officials wouldn’t be able to move forward without its approval. In a statement, he said that expanding the Medicaid program to extend coverage to Americans who currently struggle to afford the health insurance they need is a “bad idea and expensive for taxpayers.”

New Orleans isn’t the only city with frustrated officials working to provide health coverage for their low-income residents without their governor’s help. In Texas, the state with the unfortunate distinction of having its health system ranked the worst in the nation, several counties are exploring the possibility of setting up their own Medicaid expansions after Gov. Rick Perry (R-TX) refused to do so.