Hurricane Katrina’s Health Care Legacy and the Need for Medicaid Expansion in Gulf Coast States

A doctor administers an asthma breathing test.

Dr. Alan Shapiro, of the Children’s Health Fund in New York, gives an asthma breathing test to Ja’Shayna Davis in Gulfport, Mississippi, on September 13, 2005. Source: AP/Darron Cummings

Washington, D.C. —(ENEWSPF)–August 20, 2015.  One decade after the Gulf Coast states of Louisiana, Mississippi, and Alabama felt the catastrophic effects of Hurricane Katrina, the Center for American Progress examines how those states’ refusal to expand Medicaid coverage has contributed to the region’s health care coverage gap and allowed Katrina’s health impacts to linger. The 2005 storm and subsequent flooding left thousands of low-income residents suffering from physical and mental health problems—including post-traumatic stress disorder and depression—and also restricted access to medical care and prescription drugs. The federal government’s failure to respond adequately with a temporary expansion of Medicaid—as it had approved for New York following the 9/11 attacks—left many uninsured evacuees without coverage.

In a new issue brief, CAP looks at the health impacts of Katrina and the continuing barriers people in Louisiana, Mississippi, and Alabama face in accessing care. Figures in the brief include:

A September 2005 survey of New Orleans evacuees in Houston showed that one-third of respondents were suffering from injuries or health problems directly related to Katrina, one-third had gone without the medications they needed, and more than half were uninsured.

Estimates suggest that as many as 200,000 people in Louisiana alone lost employer-based health coverage due to hurricanes Katrina or Rita, and access to health care dropped drastically as doctors evacuated and clinics flooded.

Children were most at risk and suffered long-lasting mental health effects: A 2010 survey found that symptoms of serious emotional disturbance were still 4.5 times more common among children displaced by Katrina than among children from similar backgrounds in the rest of the country.

By early October 2005, almost 7,000 applications for Medicaid coverage were filed at Louisiana shelters, yet 58 percent of these applications could not be approved due to strict eligibility requirements.

In these three states today, about 450,000 uninsured people are trapped in the so-called coverage gap and would gain health coverage under Medicaid expansion.

In the years since Katrina, the creation and implementation of the Affordable Care Act has radically improved the disaster relief health care safety net, but the the Gulf Coast states’ reluctance to expand Medicaid still leaves the region’s uninsured, low-income residents in harm’s way.

“Expanding health insurance coverage is not a cure-all,” said Thomas Huelskoetter, Research Assistant for Health Policy at CAP and author of the issue brief. “Future disasters will always require specific, targeted health policy changes to provide immediate relief, as well as long-term supports, particularly to ensure access to mental health care in the following months and years. Nevertheless, Medicaid coverage alone can make a huge difference.”

Read the issue brief here.

Related resources:

Interactive Map: Why the Supreme Court’s Ruling on Medicaid Creates Uncertainty for Millions by Maura Calsyn and Emily Oshima Lee

Medicaid: The Best Safety-Net for Katrina Survivors and States by Karen Davenport