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BATON ROUGE -- The coronavirus pandemic and federal legislation have caused a spike in Louisiana's Medicaid population, adding 208,000 people to the rolls over the past year.

Nearly 1.8 million people in Louisiana -- about 39% of the state's 4.6 million residents -- were receiving health coverage through Medicaid as of last month, according to The Advocate.

"We know very well when the economy goes south, the demand for public services increases," said Jan Moller, head of the left-leaning Louisiana Budget Project, which advocates for low- to moderate-income families. "It's perfectly understandable and rational that more people would qualify for coverage."

A historic number of Louisiana residents lost their jobs this year as the pandemic and government restrictions hammered employers. Moller noted that thousands of people dropped out of the labor force entirely, many because they had to take care of children at home with schools closed or shifted to online instruction.

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Congress also has kept Louisiana's Medicaid rolls inflated.

Federal legislation gave Louisiana and other states more Medicaid money by increasing the federal share for paying some Medicaid expenses. The change meant it cost Louisiana less to cover some Medicaid enrollees, saving the state about $283 million in the previous budget year and $440 million in the current year, according to estimates. State lawmakers used much of the money to pay for other spending priorities.

In exchange for the windfall, Congress told states that they can't kick people off Medicaid during the pandemic unless the recipients move, die or request termination of their coverage, according to the Kaiser Family Foundation.

Because of the congressional provision, Louisiana's Health Department suspended a strict wage verification initiative it had enacted in the Medicaid program as Republicans pushed for tougher oversight on the people receiving taxpayer-financed health benefits.

Tara LeBlanc, interim executive director of Medicaid at the state Health Department, said approximately 160,000 people currently being covered by Medicaid are ineligible. The agency is working with the federal government on how to end coverage for people once the public health emergency ends. LeBlanc estimated it will take about six months to catch up on all the reviews to determine who is ineligible.

State Senate Republican leader Sharon Hewitt said Medicaid was designed as a safety net for people who need health coverage during tough financial times.

"I can't think of a more challenging financial climate or a bigger need for health care resources for our families than the current covid pandemic," she said. "Once this public health emergency is over and we get our people back to work, I look forward to working with the Department of Health to identify those individuals who may have needed Medicaid in 2020, but now have employer-sponsored insurance or are able to purchase health insurance on their own."

Moller said he's "extremely concerned" about what happens when the public health emergency ends and potentially hundreds of thousands of people receiving Medicaid in Louisiana lose their benefits.

"We want to make sure it's done in the most orderly, careful fashion possible," he said.

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