Southern United Neighborhoods is active in an alliance called Save Health Care in Louisiana that is calling for a constitutional amendment for the people to VOTE on Medicaid Expansion. Please read LA Breaking Barriers Report for information on the disparities in health care Louisianans face.
Louisiana has the third highest poverty level in the United States. More than one-third of our families live in medically under-served areas, and one-in-four people lack health insurance. Louisiana made an anemic attempt to enroll residents in the ACA marketplace. Resources for culturally appropriate outreach were not readily available.
Through its refusal to expand Medicaid, Louisiana has effectively stranded almost 422,000 of its residents without medical insurance – over half are people of color. This exacerbates existing racial disparities and poses a major barrier to a healthy citizenry.
During the first Affordable Care Act (ACA) enrollment period the percentage of uninsured Louisiana residents decreased only 1.5 percent, half the national rate. The number of people receiving assistance under Medicaid/CHIP actually declined by 7,904.
Kaiser Family Foundation analysts estimate of those who fall into the Medicaid Gap in Louisiana, 53 percent are African American and 67 percent are people of color.
Given both the high percent of uninsured African Americans and that they make up almost one-third of Louisiana’s population, the enrollment figures are woeful. While 69 percent of our African American survey respondents had insurance, a little more than a quarter (26 percent) were new enrollees.
An email address is necessary for enrollment. Although relatively easy to get, not having an email address suggests that the potential enrollee has minimal familiarity with Internet communications. The racial divide is significant. In our survey, 52 percent of African Americans and 25 percent of Latino people had email.
Moving from Coverage to Care
Having insurance coverage does not necessarily translate into quality care, which includes access to providers, a relationship with a personal doctor, and access to medication and other treatment.
In our survey, 64.5 percent of African Americans and 67 percent of Latinos said they have a personal doctor. Those who did not, go to the hospital or clinic.
- Increase enrollment and federal funding for health care by expanding Medicaid.
- Target enrollment of low-income residents who are already enrolled in programs like WIC, food stamps, or reduced price school meals.
- Expand the role of navigators to help people once they are enrolled to find doctors, alternative care, interpretation and health education.
- Louisiana should enforce ACA provisions requiring insurers to reduce racial disparities, and then closely monitor insurers’ disparity-reduction programs.
- Require networks to assure one full-time primary caregiver for every 2,000 patients. Increase payment rates to primary care physicians
- Make sure the newly enrolled have their free screenings and checkups within 60 days and well-woman preventative care.
- Require plans to track health outcomes, disaggregated by race, ethnicity, primary language, gender, disability, and sexual orientation.
- Encourage innovation and experimentation to address the underlying causes of poor health, particularly in poor and rural communities.
- Invest in school-based health centers in medically under-served communities.
The Alliance for a Just Society is a national policy, research and organizing network focused on racial and economic justice. The Alliance has produced pivotal reports for 20 years on state and national health issues.