Medicaid in Louisiana
Louisiana expanded Medicaid effective July 1, 2016. Governor John Bel Edwards signed the expansion executive order on his first day in office, making Louisiana the first Deep South state and the 31st state overall to expand. The expansion covers adults aged 19 to 64 earning up to 138% FPL (about $22,025 for a single person, or $45,540 for a family of four, for 2027 coverage).
The impact was immediate and dramatic. Within the first year, over 400,000 adults enrolled. Total expansion enrollment has exceeded 500,000. Louisiana's Medicaid program, called Healthy Louisiana, uses five managed care organizations to administer benefits: Aetna Better Health, AmeriHealth Caritas, Healthy Blue, Louisiana Healthcare Connections, and UnitedHealthcare Community Plan.
Before expansion, Louisiana's uninsured rate was about 16%, one of the highest in the nation. It has dropped to roughly 7 to 8%. About 350,000 Louisianans remain uninsured, many of whom are eligible for Medicaid or marketplace subsidies but have not enrolled.
Starting in 2027, federal law requires work requirements for most Medicaid expansion adults. States must start by January 1, 2027 (a state making a good-faith effort can get extra time). Adults ages 19 to 64 in the expansion group will generally need to show 80 hours a month of work, school, job training, or community service. Parents of children under 14, pregnant people, people who are disabled or medically frail, and some others are exempt. Watch for notices from the Louisiana Department of Health.
What plans cost in 2027
Premiums rose again for 2027. Here is the benchmark (second-lowest cost Silver) premium for a 40-year-old before subsidies, from HealthCare.gov plan data:
- Orleans Parish (New Orleans): about $686 per month, up from $582 in 2026
- East Baton Rouge Parish: about $710, up from $612
- Caddo Parish (Shreveport): about $641, up from $542
- Lafayette Parish: about $786, up from $730
Your actual price depends on your age, parish, tobacco use, and the plan you choose. Because tax credits are tied to the benchmark plan, subsidies generally rise along with it if your income stays steady.
About 297,000 Louisianans picked a marketplace plan during 2026 open enrollment, according to CMS. The enhanced premium tax credits expired after 2025 and were not renewed. For 2027, people above 400% FPL ($63,840 for an individual, $132,000 for a family of four) get no premium tax credit, and people below that line pay a larger share of their income than they did in 2025.
Carriers in Louisiana (2027)
Five insurance companies offer individual marketplace plans in Louisiana for 2027:
- Blue Cross and Blue Shield of Louisiana (including its HMO Louisiana plans) is the dominant insurer in the state and the only one offering plans in all 64 parishes. BCBSLA has the broadest provider network, including major systems like Ochsner Health, LCMC Health, and Our Lady of the Lake. For many Louisianans, especially those outside the New Orleans and Baton Rouge metros, BCBS is the primary or only marketplace option.
- UnitedHealthcare sells plans in 48 parishes for 2027, the second-widest footprint in the state, including Baton Rouge, Shreveport, and Lafayette.
- AmeriHealth Caritas Next sells plans in 25 parishes, including New Orleans, Baton Rouge, and Lafayette.
- Ambetter from Louisiana Healthcare Connections (a Centene subsidiary) sells plans in 24 parishes, focused on the more populated areas. Networks tend to be narrower, and premiums are often lower.
- CHRISTUS Health Plan sells plans in 8 parishes for 2027, including Caddo Parish, with networks built around CHRISTUS hospitals.
Most metro parishes have four or five insurers for 2027. In many rural parishes, the choice is Blue Cross plus one or two others.
Key regions
New Orleans metro
Orleans, Jefferson, and St. Tammany parishes have the strongest healthcare infrastructure in the state. Ochsner Medical Center is the largest hospital in Louisiana and a major academic medical center. LCMC Health operates University Medical Center (the safety-net hospital that replaced the old Charity Hospital), Touro Infirmary, Children's Hospital, and other facilities. Tulane Medical Center and LSU Health Sciences Center round out the academic presence. Multiple marketplace carriers typically compete in this area.
Baton Rouge
East Baton Rouge Parish is served by Our Lady of the Lake Regional Medical Center (the largest hospital in the capital region), Baton Rouge General, and the new Ochsner Baton Rouge campus. LSU Health Baton Rouge provides additional academic medical resources. Carrier competition is typically good in the Baton Rouge area.
Shreveport and northern Louisiana
Caddo Parish (Shreveport) is served by Ochsner LSU Health Shreveport, Christus Health Shreveport, and Willis-Knighton Health System. Northern Louisiana is somewhat isolated from the rest of the state's healthcare infrastructure. Caddo Parish has five insurers for 2027, including CHRISTUS Health Plan, but options thin out in smaller northern parishes.
Rural Louisiana
Much of rural Louisiana, particularly the central and north-central parishes, faces provider shortages and limited hospital access. Several rural hospitals have closed or converted to other uses. Community health centers are critical for primary care access in these areas. If you live in a rural parish, verify that your plan has adequate in-network providers nearby. Blue Cross is the only insurer in every parish and typically has the broadest rural network.
Estimate your subsidy
Subsidy Estimator
Enter your info below to get a rough estimate of your monthly premium tax credit for a 2027 marketplace plan.
Louisiana-specific things to know
Medicaid expansion dramatically changed the landscape. Before 2016, Louisiana had one of the worst uninsured rates and health outcomes in the country. Expansion alone covered more than 500,000 people. If your income is below 138% FPL, check Healthy Louisiana Medicaid before shopping the marketplace. Medicaid has no premiums and minimal cost-sharing.
Hurricane and disaster considerations. Louisiana is prone to hurricanes and flooding. After a federally declared disaster, special enrollment periods may open for affected individuals. Keep your insurance documents in a safe, accessible place and know how to contact your insurer in an emergency. Most carriers have disaster response procedures that relax prior authorization requirements and allow out-of-network care temporarily.
Louisiana uses parishes, not counties. When entering your location on HealthCare.gov, you will select your parish. Louisiana is the only state that uses this terminology, but the marketplace handles it the same way as counties in other states.
Resources
- HealthCare.gov for marketplace enrollment (Louisiana uses the federal marketplace)
- Louisiana Department of Health — Medicaid for Medicaid and Healthy Louisiana enrollment
- Louisiana Department of Insurance for consumer assistance and insurance complaints