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.
Due to the ongoing COVID pandemic, and to give people an opportunity to take advantage of the improved premium subsidies created by the American Rescue Plan, a special enrollment period is open through August 15, 2021. Louisiana residents can use this enrollment window regardless of whether they have a qualifying event. Plans selected during this window will take effect the first of the month following enrollment.
Outside of the open enrollment period, which runs from November 1 to December 15, Louisiana residents can normally only enroll in individual major medical health coverage if they experience a qualifying event (this applies regardless of whether the plan is purchased through the exchange or directly through an insurance company). But the COVID-related enrollment window in 2021 is essentially an open enrollment window, giving people an opportunity to newly enroll in individual and family health plans, or to switch to a different plan if it will better suit their needs (in some cases, switching plans will allow people to best utilize the additional premium subsidies under the American Rescue Plan).
Open enrollment for 2022 health insurance plans will start on November 1, for coverage effective January 1, 2022. Between August 16 and October 31, Louisiana residents will still be able to enroll in coverage or make a plan change if they experience a qualifying event.
As of 2020, Christus joined three other insurers – Blue Cross and Blue Shield of Louisiana, HMO Louisiana, and Vantage Health Plan – in offering medical insurance plans through Lousiana’s health insurance marketplace. Service areas vary from one insurer to another, however, so plan availability varies across the state.
Louisiana’s insurers implemented an overall average rate increase of 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.
Enrollment in private plans through Louisiana’s exchange had dropped to a record low of just over 83,000 people by the end of the open enrollment period for 2021 coverage. (More than 214,000 people had been enrolled as of 2016.)
But 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 instead, 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.
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 will still be operational as of 2021.
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 2020, 91% were receiving premium subsidies and 52% were receiving cost-sharing reductions.
And Medicaid expansion has helped hundreds of thousands of low-income Louisiana residents obtain coverage and life-saving treatment: 617,709 people were enrolled in expanded Medicaid as of March 2021, 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 (Cedric Richmond), 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 2021, nearly 618,000 people were enrolled in expanded Medicaid coverage in Louisiana. This was a substantial increase from the end of 2019, when about 456,000 people had been enrolled.
But the COVID-19 pandemic has been driving Medicaid expansion higher nationwide, as job losses and income reductions make people newly eligible for Medicaid coverage – including people who were previously employed (and potentially enrolled in health coverage offered by their employers) or running a small business.
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. But the regulations are clear in noting that states may continue to have more restrictive rules.
Louisiana state insurance regulations limit initial duration of short-term health insurance plans in Louisiana to six months, but only if the insurer looks back more than 12 months to determine whether the applicant has pre-existing medical conditions. If the insurer only considers the applicant’s past 12 months of medical history, the plan can have an initial duration of up to 364 days. Some of the insurers that offer short-term health insurance plans in Louisiana do look back more than 12 months when considering an applicant’s medical history, so their plans are capped at six months.
The state does not, however, limit or prohibit renewal of plans, nor subsequent purchases of additional short-term health insurance coverage.
Read more about short-term health insurance plans in Louisiana.
As of March 2021, there were 888,125 Medicare beneficiaries in Louisiana. About 46% are enrolled in Medicare Advantage plans, which is slightly higher than the national average. The other 54% were enrolled in Original Medicare (this includes Medicare Part A, which provides hospital benefits, and Medicare Part B, which provides outpatient benefits).
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.