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Louisiana health insurance

Four insurers are offering 2021 plans through the Louisiana health insurance marketplace; COVID-related enrollment period continues through August 15, 2021

Health insurance in Louisiana

This page is dedicated to helping consumers quickly find health insurance resources in the state of Louisiana. Here, you’ll find information about the many types of health insurance coverage available. You can find the basics of the Louisiana health insurance marketplace, including the annual0 open enrollment period and the COVID-related enrollment window in 2021. We’ve also included a brief overview of Medicaid expansion in Louisiana; information about short-term health insurance availability in the state; details about Medicare in Louisiana; as well as a collection of health insurance resources for Louisiana residents.

Louisiana’s health insurance marketplace

Louisiana operates a federally facilitated health insurance marketplace, so residents use to enroll in exchange plans.

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.

All four insurers continue to offer plans in the Louisiana exchange in 2021. They 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 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.

When can I enroll in health insurance in Louisiana?

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.

Medicaid expansion in Louisiana

In 2015, there were 192,000 Louisianans in the Medicaid coverage gap, meaning they didn’t qualify for Medicaid coverage or Obamacare subsidies to help make health insurance affordable.

But 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.

Short-term health insurance in Louisiana

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.

How has Obamacare helped Louisiana?

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 and the Affordable Care Act

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.

Does Louisiana have a high-risk pool?

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.

Other ACA reform provisions

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.

Medicare coverage and enrollment 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).

More than 310,000 Louisiana Medicare beneficiaries are enrolled in stand-alone Medicare Part D plans, and more than 392,000 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.

Louisiana health insurance resources

Health reform legislation in Louisiana

Scroll to the bottom of this page to see a summary of recent Louisiana legislation related to health care reform:

Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.

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