HJNO Jul/Aug 2026

DIALOGUE 14 JUL / AUG 2026 I  HEALTHCARE JOURNAL OF NEW ORLEANS Editor LDH is preparing for Medicaid work requirements beginning January 1st of next year, 2027. Is that correct? Greenstein Yeah, that’s right. Editor So critics worry that this will become less of an eligibility screening and more of a coverage purge for people who are eligible but miss paperwork or can’t navigate the process. How many Louisianans have lost coverage during your tenure and how many do you estimate would lose coverage next year? Greenstein So you ask a question that is leading, but is not sufficient to get a proper answer because when you talk about— Editor All right, well, help me out there. Greenstein Losing coverage and losing eligibility are two things. So I’ll just start out with, you think it’s a good idea for Louisiana taxpayers to pay for a Medicaid card for somebody that has Medicaid from another state already?That’s a question. Do you think it’s proper for Louisiana taxpayers to pay for Medicaid for somebody that lives in another state and not live in Louisiana? That’s another direction to look at. So that’s — the people that have been dropped from Medicaid this past year were still generally those that were caught in the expansion of Medicaid during the pandemic when states were not allowed to determine eligibility. It was a one-way street. If you get on, you’re on Medicaid and you can’t get off. In fact, last year we had to install what we call the Medicaid unsubscribe button on our website because there were families that were calling the department that had private health insurance that didn’t want Medicaid, didn’t need Medicaid, and they wanted the department to please disenroll them and there was no function to disen- roll families. In fact, they were just caught up. This happened a couple times, and fami- lies were just sent their renewal cards rather than determining eligibility. So when I talk about running the most efficient Department of Health in the coun- try, part of it is the integrity of our program. We want to make sure that everybody on Medicaid that has access to all healthcare that is available in the Medicaid program, that those people are actually eligible for the benefits. So we’ve run a program to identify people that have coverage in other states, or that have a driver’s license in another state and don’t live here anymore. And in fact, we asked everyone that had not had one Med- icaid claim in the last two and a half years if they still want Medicaid, if they still live here, and a large portion were living out of the state; they weren’t eligible for Medicaid here, and then some portion wrote back and they said, “Yep, here, feel fine but want to stay on Medicaid,” and we’ll very happily keep those people on Medicaid. So our work that we’ve done this year is to enhance integrity, public trust, and to assure the sustainability of the program for those that are on it. So that’s what I mean about those that have eligibility versus cov- erage. So our goal is to keep everybody that is eligible for Medicaid with coverage. Editor I guess the impression is that those people should have been dropped anyway. You’re saying they were held up because of the COVID requirements? Greenstein That’s right. Editor How much are you seeing in actual fraud? Greenstein Well, so you can’t determine from these measures if somebody was applying and staying on Medicaid fraudulently; that would somehow suppose that they were lying on their applications. That’s not what we were going out to detect. This is a complete separate line of effort. We do constantly monitor those that are creating fraud either as a provider or as a recipient. You might have noticed a woman that had over $600,000 of annual income and she had just bought a Maserati yet continued to reapply for Medicaid actively, and we sent her information to the attorney general and I believe they arrested her. So we continue to take action like that, but this past year, we’ve just been cleaning up the Medicaid rolls, and just taking people that are not eligible for the program off the program. Editor And what percent would you say had moved out of state of the people you took off? Greenstein I don’t have the data in front of me, but it was substantial. Editor The majority, would you say? Greenstein Again, I’d have to take a look at the data before I speak to each individual piece. Editor Can we get a breakdown of the people that were removed as a chart for this story that would show? Greenstein I don’t know if we’ll have it in time for your story, but we’re going to publish an article on this so that you’ll have all the data when we have it available. Editor Thank you. Greenstein Sure. Editor Louisiana continues to face serious maternal and infant health challenges, particularly among underserved women, and women in rural communities. What is the greatest health issue facing these underserved women during pregnancy, childbirth, and the neonatal period, and what are you doing to measurably improve outcomes? Greenstein Yeah, this is an area that we are significantly focused on. We want to see change around it, and we do have in rural