Including more poor residents in Louisiana’s Medicaid health-care program would cost the state almost $4 billion over 10 years, the head of the state Department of Health and Hospitals said Monday.

Bruce Greenstein, secretary of the department, put the tab for an expanded program at $3.7 billion over the next decade, triple the $1.2 billion estimate in a new study by the Kaiser Commission on Medicaid and the Uninsured.

The Medicaid program is administered by the states, he noted, and should be tailored to local conditions.

“Instead of rushing to expand, federal officials should first engage in meaningful discussions with states like Louisiana who are eager to further reform their existing programs now, rather than spend more money on a one-size-fits-all program that won’t work for states,” Greenstein said in response to the Kaiser report.

Expanding Medicaid in Louisiana would extend health coverage to another 398,000 people by 2022, the Kaiser report said.

A larger Medicaid roll would reduce the number of low-income residents without health insurance, saving the state $267 million a year currently spent on indigent health care, Kaiser said.

An expanded Medicaid program is part of the federal Affordable Care Act, but the Supreme Court decision that upheld the constitutionality of the federal health care law gave states the option to reject the expansion.

Gov. Bobby Jindal said in June that Louisiana would not participate in the Medicaid expansion.

The federal government will pay for 100% of the costs in the first three years of expanded state programs, but the reimbursement level then drops to 90%.

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