Frequently asked questions about health insurance coverage options in Louisiana
Louisiana operates a federally facilitated health insurance marketplace, so residents use HealthCare.gov to enroll in exchange plans. Learn more about the Louisiana health insurance marketplace.
Open enrollment for individual/family health insurance runs from November 1 to January 15 in Louisiana. Outside of open enrollment, a qualifying event is generally necessary to enroll or make changes to your coverage. Learn more in our guide to special enrollment periods.
In Louisiana, consumers who aren’t eligible for an employer’s health plan may be able to buy affordable individual and family health insurance by enrolling through the ACA marketplace (HealthCare.gov). During the open enrollment period for 2023 coverage, 94% of Louisiana marketplace enrollees qualified for premium subsidies, which offset a significant portion of the cost of coverage.
Louisianans with limited income may find that they’re eligible for coverage through the state’s Medicaid program. See Medicaid eligibility guidelines in Louisiana.
For the very small minority of people who aren’t eligible for employer-sponsored coverage, Medicare, Medicaid, or premium subsidies in the marketplace, short-term health insurance can be an option for lower-cost coverage, although these plans have drawbacks in terms of benefits and consumer protections. Learn more about short-term health insurance in Louisiana.
As of 2023, there are six insurers that offer exchange plans in Louisiana. The most recent additions were Ambetter from Louisiana Healthcare Connections, and UnitedHealthcare, both of which joined the exchange for 2022. (UnitedHealthcare previously offered coverage in the Louisiana exchange in 2015 and 2016, but did not participate from 2017 through 2021.)
The following insurers offer plans in the Louisiana exchange for 2023, with plan availability varying from one location to another:
- Ambetter from Louisiana Healthcare Connections
- Blue Cross Blue Shield of Louisiana
- HMO Louisiana
- Vantage Health Plan
According to ratereview.healthcare.gov, Louisiana’s exchange insurers implemented the following average rate changes for 2023:
- Blue Cross Blue Shield of Louisiana (Louisiana Health Service and Indemnity Company): 21.9% decrease.
- HMO Louisiana (a subsidiary of Blue Cross Blue Shield of Louisiana): 2.2% increase.
- Vantage Health Plan: 5.8% increase.
- Christus Health Plans: 9.6% increase.
- Ambetter from Louisiana Healthcare Connections: 10.4% increase.
- UnitedHealthcare: 9.1% increase.
Those rate changes followed weighted average increases of about 4.75% for 2022, and about 6.9% for 2021. This was one of the larger average rate increases across the country for 2021, and it came on the heels of an average rate increase of 11.7% in 2020; Louisiana was one of only three states with a double-digit average rate increase that year.
But as of early 2023, more than 94% of Louisiana marketplace enrollees were receiving premium subsidies. The American Rescue Plan increased the size of premium subsidies in 2021, and made subsidies more widely available; those provisions have been extended through 2025 by the Inflation Reduction Act. So although average full-price premiums increased in Louisiana in 2021, 2022, and 2023, most enrollees have likely found that their coverage continues to be more affordable than it was prior to 2021, thanks to the enhanced subsidies.
During the open enrollment period for 2023 coverage, 120,804 people enrolled in private qualified health plans (QHPs) through Louisiana’s exchange. Enrollment the year before had been under 100,000 people. The state’s 2023 enrollment was the highest it had been since 2016. The increased enrollment was driven largely by the enhanced affordability created by the American Rescue Plan.
Louisiana expanded eligibility for Medicaid in mid-2016, resulting in a substantial number of low-income people – many of whom had been enrolled in heavily subsidized private plans through the exchange – gaining eligibility for Medicaid and transitioning away from their private coverage. (In many other states, Medicaid expansion took effect in 2014, at the same time that exchange enrollment initially became available, so the sort of enrollment shifting that happened in Louisiana from 2016-2018 didn’t happen in those states.)
Read more about Louisiana’s health insurance marketplace and Medicaid expansion.
The ACA’s Consumer Operated and Oriented Plan (CO-OP) Program was established to promote market competition through nonprofit, consumer-run health insurance companies. Twenty-four CO-OPs received loans totaling $2.09 billion as of January 2014, but most failed in the first few years and only three are still operational as of 2022.
Louisiana Health Cooperative received a $65.8 million start-up loan. Louisiana Health Cooperative competed against Blue Cross and Blue Shield of Louisiana, Vantage Health Plan, and Humana during 2014 open enrollment, but struggled with its enrollment goals.
On July 24, 2015, Louisiana’s CO-OP announced it would continue to cover enrollees until the end of the year but would not sell plans in 2016. People who were enrolled in Louisiana Health Cooperative plans in 2015 needed to transition to plans offered by other insurers for 2016.
Louisiana’s uninsured rate dropped from 16.6% in 2013 to 10.3% in 2016, but it was still above the 8.6% national average at that point. But as Medicaid expansion took effect in mid-2016, Louisiana’s uninsured rate had dropped to 8 by 2018 – below the national average of 8.9%. It grew to 8.9% in 2019, but the national average also climbed, to 9.2% (the nationwide uninsured rate trended upward under the Trump administration).
For those who have purchased health insurance in Louisiana, the ACA has helped make coverage more affordable. Of those enrolled in plans through the Louisiana exchange as of 2023, more than 94% were receiving premium subsidies and 47% were receiving cost-sharing reductions.
And Medicaid expansion, which is a cornerstone of the ACA, has helped hundreds of thousands of low-income Louisiana residents obtain coverage and life-saving treatment: More than 773,000 people were enrolled in expanded Medicaid as of early 2023, and nearly three-quarters of them had been to the doctor at least once during the year.
Louisiana’s Senate delegation is currently entirely Republican – Bill Cassidy and John Kennedy, both of whom are opposed to the ACA. Cassidy in particular, played a pivotal role in 2017 in the GOP’s ultimately unsuccessful efforts to repeal the ACA. In the House of Representatives, Louisiana has just one Democrat (Troy Carter), who supports the ACA.
At the state level, Louisiana’s legislature is dominated by Republicans, and the ACA has not gained traction. While legislation to establish a state-run health insurance marketplace was considered, it did not pass.
Former Gov. Bobby Jindal, whose term ended in January 2016, strongly opposed the Affordable Care Act. He returned a $1 million federal planning grant for exploring a state-run insurance marketplace, defaulted to the federally facilitated marketplace, and rejected Medicaid expansion.
Gov. Jindal was replaced in 2016 by John Bel Edwards, a Democrat who supports the ACA. One of Edwards’ first actions as governor was to expand Medicaid coverage in Louisiana.
Louisiana implemented the Affordable Care’s Medicaid coverage expansion in June 2016. As of March 2023, more than 773,000 people were enrolled in expanded Medicaid coverage in Louisiana (ie, Healthy Louisiana). This was a substantial increase from the end of 2019, when about 456,000 people had been enrolled.
But the COVID-19 pandemic drove Medicaid expansion higher nationwide, particularly due to the COVID-related ban on Medicaid disenrollments that was in place from March 2020 through March 2023.
Read more about Louisiana’s Medicaid expansion.
Current federal regulations allow short-term health insurance plans to have initial terms of up to 364 days, and total duration – including renewals – of 36 months.
And Louisiana’s insurance regulations (Title 22) define short-term health insurance to align with the federal rules.
Several insurers offer short-term health plans in Louisiana, including some of the insurers that also offer ACA-compliant plans in the state’s exchange/marketplace. Some insurers offer plans with terms and durations up to the federal limits, while others restrict their plans to shorter terms and/or do not offer renewals.
Read more about short-term health insurance plans in Louisiana.
As of late 2022, there were more than 911,000 Medicare beneficiaries in Louisiana. Enrollment is split nearly equally between Medicare Advantage plans and Original Medicare (Original Medicare includes Medicare Part A, which provides hospital benefits, and Medicare Part B, which provides outpatient benefits), although Medicare Advantage now covers more beneficiaries in Louisiana than Original Medicare (nationwide, about 46% of Medicare beneficiaries).
Nearly 288,000 Louisiana Medicare beneficiaries are enrolled in stand-alone Medicare Part D plans, and more than 445,000 have Part D coverage integrated with Medicare Advantage plans.
Learn more about Medicare plans in Louisiana, including the state’s rules for companies that provide Medigap plans in Louisiana, and how to compare costs and benefits provided by the various private Medicare plan options.
- Department of Health & Hospitals
- Louisiana Department of Insurance — Health Insurance Resources
- Medicare Rights Center (a nationwide service that includes a website and call center)
- Louisiana Senior Health Insurance Information Program (a resource for Medicare beneficiaries)
- HealthCare.gov (the health insurance marketplace that Louisiana residents use to purchase their own health coverage)
- Louisiana Department of Health, Medicaid office
The Louisiana Health Plan was created in 1992 in order to provide a coverage option for state residents who couldn’t get private plans in the individual market because of their medical histories.
But Obamacare’s guaranteed issue provision means that pre-existing conditions are now covered on all policies, and are no longer factored into the application process. As a result, the need for high-risk pools no longer exists the way it once did. The Louisiana Health Plan terminated all coverage on December 31, 2014, per the terms of House Bill 638 (passed in June 2013). Members were able to transition to new ACA-compliant plans instead.