Gizmo Warehouseby Joe Eichenbaum | 17A

Medicaid work requirements · Louisiana

Medicaid work requirements in Louisiana: who is subject and who loses coverage (2027)

Data snapshot 2026-06-03 · part of These 5 Million People Are About to Lose Their Medicaid — But They Don't Have To

Louisiana expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 694,371 of them (25.7% of an expansion pool of 742,292) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.

This model's bottom-up estimate is that 261,774 people in Louisiana lose coverage by 2034: 240,943 of them still eligible but lost to paperwork and reporting failures, and 20,831 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.

Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Louisiana scores 69 of 100 on this model's ex parte capability index, a mid band; its eligibility system is LaMEDS.

Key figures

Model v2-2026-06-03. "Strict" counts adults whose ACS record shows them subject with no observable exemption; "permissive" allows the broader exemption reading.
MeasureLouisiana
Expansion stateYes
Subject to the requirement via waiverNo
Expansion pool (adults 19 to 64)742,292
Adults subject, strict definition694,371
Adults subject, permissive definition680,484
Share of expansion pool subject25.7%
Projected coverage loss by 2034261,774
Hardship exception statusAdopting
Early implementerNo
Ex parte capability score (0 to 100)69 (mid)

Who is subject in Louisiana

Of the 694,370 subject adults, 39% already work 80 or more hours a month and 56% are not working. 37% have a child under 14 at home. Among those not working, 46% report a disability and 17% are caregivers.

ACS PUMS 5-year 2020 to 2024, subject adults only.
CharacteristicShare of subject adults
Age 19-2416%
Age 25-3423%
Age 35-4420%
Age 45-5417%
Age 55-6423%
Not working56%
1 to 19 hours a month1%
20 to 79 hours a month4%
80 or more hours a month (meets the bar)39%
Not working: Disabled46%
Not working: Caregiver17%
Not working: Postpartum0%
Not working: Student3%
Not working: Other33%

Why eligible people lose coverage

Of the 261,774 projected to lose coverage in Louisiana, 240,943 meet the requirement or qualify for an exemption but fail to document it. 103,358 of those are working people who cannot prove their hours through data the state can see, and 137,585 qualify for an exemption the state does not detect automatically.

Bottom-up model v8.0-2026-05-30; documentation-failure buckets compound over the 14 six-month renewal cycles through 2034.
GroupProjected to lose coverage
Variable shifts / on-call work33,952
Self-employed (other)20,886
Multiple part-time jobs (aggregation failure)18,896
Full-time students not auto-verified8,885
Volunteering / job training7,683
Seasonal: agriculture, hospitality, food service5,461
Cash-paid construction & trades4,847
Gig / courier (DoorDash, Uber, Lyft, Instacart)2,748
Medically frail without auto-match36,284
Caregivers of a disabled adult32,202
Parent caregivers of children ≤13 without auto-match32,167
Kinship caregivers (non-parent) of children ≤1314,085
American Indian / Alaska Native (tribal exemption)8,662
SUD treatment not flagged in claims data5,584
Recent incarceration (data-match gap)4,559
Other categorical exemptions (foster, AYA cancer, SNAP/TANF)3,585
Pregnancy / postpartum data lag457

Can the state renew people automatically?

The ex parte capability index blends the state's observed automatic-renewal rate (78% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Louisiana's composite score is 69 (mid band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.

ComponentScore
Composite69
Observed ex parte78
Core capability47
Data sources65
Historical churn50

How subjects overlap across exemption categories

Each subject adult sits in exactly one cell. Categories: Working ≥ qualifying hours / income; Parent caregiver of child ≤13; Medically frail; Full-time student.
CombinationAdultsShare
None of the four260,07837.5%
Working ≥ qualifying hours / income136,03519.6%
Working ≥ qualifying hours / income + Parent caregiver of child ≤13100,13214.4%
Medically frail92,26813.3%
Parent caregiver of child ≤1340,9585.9%
Full-time student20,7613.0%
Working ≥ qualifying hours / income + Full-time student15,0902.2%
Working ≥ qualifying hours / income + Parent caregiver of child ≤13 + Full-time student10,4341.5%

Counties in Louisiana

Subject adults concentrate: East Baton Rouge Parish (72,842), Jefferson Parish (64,695), and Orleans Parish (51,333) account for 27% of the state's subject population.

All 64 counties in Louisiana with subject adults, sorted by count. County figures are model allocations of the state estimate by ACS tract characteristics.
CountyAdults subjectSubject rateProjected lossPoverty rateWorking-age population
East Baton Rouge Parish72,84226.8%27,46118.0%271,800
Jefferson Parish64,69525.9%24,39015.0%249,943
Orleans Parish51,33322.3%19,35223.0%229,906
St. Tammany Parish42,47527.4%16,01312.0%154,879
Lafayette Parish35,68823.9%13,45417.0%149,070
Caddo Parish33,69925.9%12,70422.0%129,943
Calcasieu Parish31,31226.1%11,80517.0%119,826
Ouachita Parish23,51125.5%8,86423.0%92,319
Livingston Parish21,95825.0%8,27812.0%87,891
Tangipahoa Parish20,82526.0%7,85119.0%79,979
Ascension Parish18,85924.2%7,11010.0%77,802
Bossier Parish18,65924.5%7,03417.0%76,166
Rapides Parish18,64925.7%7,03118.0%72,563
Terrebonne Parish15,88925.8%5,99016.0%61,603
Lafourche Parish14,54625.5%5,48417.0%57,088
St. Landry Parish12,51727.7%4,71927.0%45,179
Iberia Parish10,61827.3%4,00323.0%38,945
Lincoln Parish9,88432.9%3,72630.0%30,026
Acadia Parish8,73827.2%3,29424.0%32,152
Vermilion Parish8,66926.6%3,26819.0%32,586
St. Charles Parish8,21526.9%3,09710.0%30,510
St. Martin Parish8,09727.3%3,05318.0%29,696
St. Mary Parish7,46627.9%2,81522.0%26,775
Washington Parish6,73626.6%2,53924.0%25,312
Natchitoches Parish6,51230.9%2,45526.0%21,045
St. Bernard Parish6,50624.6%2,45323.0%26,452
St. John the Baptist Parish6,31026.1%2,37914.0%24,160
Vernon Parish5,78220.7%2,18018.0%27,961
Beauregard Parish5,61526.7%2,11713.0%21,040
Webster Parish5,57028.0%2,10028.0%19,931
Avoyelles Parish5,51824.8%2,08028.0%22,232
Jefferson Davis Parish5,03327.8%1,89816.0%18,078
Evangeline Parish4,81226.4%1,81428.0%18,263
Iberville Parish4,33923.7%1,63617.0%18,296
De Soto Parish4,03626.5%1,52120.0%15,257
West Baton Rouge Parish3,76722.5%1,42015.0%16,742
Morehouse Parish3,76127.6%1,41829.0%13,626
Sabine Parish3,61830.3%1,36424.0%11,920
Union Parish3,53631.1%1,33327.0%11,370
Pointe Coupee Parish3,42730.7%1,29219.0%11,152
Assumption Parish3,38028.3%1,27416.0%11,932
Plaquemines Parish3,34224.3%1,26015.0%13,735
Grant Parish3,15322.8%1,18915.0%13,804
St. James Parish3,05027.6%1,15011.0%11,069
Richland Parish3,00626.7%1,13324.0%11,268
Allen Parish3,00121.9%1,13120.0%13,712
Franklin Parish2,99528.4%1,12926.0%10,554
Concordia Parish2,93428.7%1,10634.0%10,210
East Feliciana Parish2,84023.9%1,07115.0%11,878
Jackson Parish2,22426.0%83926.0%8,548
Bienville Parish2,18731.4%82431.0%6,967
LaSalle Parish2,14324.6%80815.0%8,719
West Feliciana Parish1,98719.2%74914.0%10,326
Claiborne Parish1,81822.9%68533.0%7,955
St. Helena Parish1,81028.9%68227.0%6,266
Winn Parish1,75521.5%66220.0%8,162
West Carroll Parish1,46228.0%55119.0%5,230
Caldwell Parish1,36124.5%51325.0%5,564
Madison Parish1,26924.0%47838.0%5,283
Red River Parish1,22529.5%46225.0%4,149
Catahoula Parish1,11422.3%42025.0%4,991
East Carroll Parish93320.7%35240.0%4,504
Cameron Parish73326.3%27612.0%2,782
Tensas Parish63033.0%23835.0%1,910

State brief and methodology

Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.

Sources

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