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.

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