Back in the spring, New Orleans’ top health official came to the City Council with grim warnings. The governor was refusing to expand the state’s Medicaid program in line with the Obama administration’s health care overhaul, and the temporary federal dollars that have kept local clinics open for more than 60,000 of the region’s poor were set to run out at year-end.
On Monday, New Orleans Health Commissioner Karen DeSalvo returned to the council with better news. After a deal reached late last month with the state, the network of clinics that took over much of the work handled at Charity Hospital before Hurricane Katrina will continue serving low-income residents in Orleans, Jefferson, Plaquemines and St. Bernard Parishes — at least for now.
“People in our community who are the working poor, particularly those who have low incomes, will be able to continue accessing the really great, neighborhood-based, quality care that’s available to them,” DeSalvo said.
The arrangement that will keep those clinics open was not the city’s first choice. DeSalvo was among those lobbying Gov. Bobby Jindal to accept the expansion of Medicaid called for under the Affordable Care Act, or Obamacare. In that scenario, the federal government would have picked up the full cost for low-income individuals to get primary and mental health care for the first three years, an idea Jindal resisted because of the potential costs that would have begun to accrue after that.
But Jindal also initially resisted extending the arrangement that has kept clinics funded so far. Since 2010, a federal waiver has allowed adults in the area to receive care through nonprofit clinics — even if they don’t qualify for Medicaid — as long as they earn less than 200 percent of the federal poverty line. But the Louisiana Department of Health and Hospitals said last month that the state would extend the waiver, freeing up about $6 million worth of federal grant dollars to keep clinics funded.
The deal came with one major caveat. Starting Jan. 1, residents will only qualify if they earn up to 100 percent of the poverty line, not 200 percent. DeSalvo estimates that 85 percent of the 63,000 residents receiving care now will still qualify. But the rest will have to seek insurance through the new health care exchanges that will come online on Oct. 1 as a part of the Affordable Care Act.
“We have to be very aggressive to make sure those folks get enrolled in the marketplace,” DeSalvo said.
She acknowledged that the region will be in the same spot next year, looking for another extension or — doubtful given Jindal’s position — an expansion of Medicaid to cover more of the working poor.
But the latest deal should at least keep those already receiving care funded through the end of 2014. Councilwoman LaToya Cantrell, who chairs the Health, Education, and Social Services Committee, said, “To know that our families will be at least protected through next year is a win.”
Residents looking to enroll under the waiver program can get more information by visiting, www.nola.gov/gnochc, calling 1-888-342-6207 or texting the word “HEALTH” to (504) 388-7580.