(Citizens for a New Louisiana) — As Iago quipped in Disney’s Aladdin, “Oh, there’s a big surprise! That’s so incredible, I think I’m gonna have a heart attack and die from not surprise!” That’s exactly how we felt, cracking open the Louisiana Legislative Auditor’s latest report on the Louisiana Department of Health (LDH). The headline? Over $103 million in Medicaid payments for people who don’t live here.

Yes, you read that right. Louisiana’s generous taxpayers shelled out more than $103 million in Medicaid payments to managed care organizations (MCOs) for over 22,000 adults who don’t even live in Louisiana. What’s worse — how could this possibly get any worse? This is the second time auditors have rung this same alarm bell.

Second Verse, Same as the First

In August 2023, the Legislative Auditor flagged this exact problem. Their recommendation? Use driver’s license data from the Louisiana Office of Motor Vehicles (OMV) to spot people who’ve moved out of state. Logical, right? But by March 2025—19 months later—LDH still hadn’t run the analysis. Only after this follow-up report was underway did they suddenly announce they’d run their first check using OMV data in April 2025. What took so long?

If this sounds familiar, it should. The government is notorious for not caring how it spends taxpayer dollars. This might remind you of Carencro, where the city forked over $26,752 in December for sidewalk repairs that never happened. Of course, they got busy fast when we started asking about the unfinished work six months later. The invoice was sent (meaning the work was reported as being complete), and the city just sent money. Not only did they not check the workmanship, they didn’t even verify that the work was done!

But the Damage Was Done:

• $774,051 went to cover people LDH already knew had out-of-state addresses in their system.
• $102.3 million covered people who’d obtained driver’s licenses in other states, meaning they legally declared residency elsewhere.
• Another 7,973 enrollees received care only from out-of-state providers despite being enrolled in Louisiana’s Medicaid program.

While LDH pinky-promises that they’ll start cleaning house based on the April 2025 OMV data match, they’re only looking to remove 9,000 people, representing just 40% of the out-of-state population identified by the auditors.

So what’s LDH’s excuse? Mostly a shrug. They blame “system limitations,” case workers not following up, or paperwork returned with no forwarding address. In one instance, a beneficiary was known to be in Mississippi as early as 2021, but Louisiana kept paying premiums until August 2024. They never used Medicaid. LDH never followed up. Louisiana taxpayers picked up the tab—over $6,000 for nothing.

If Louisiana’s Medicaid program were a business, it would be bankrupt. If it were a private insurance company, someone would’ve been fired. But since it’s government, we get a shrug and the pinky promise that “we’ll do better… next time.”

You Clearly Aren’t Paying Enough Taxes

This isn’t just a case of bureaucratic bungling; it’s a slap in the face to Louisiana taxpayers. At a time when the state has been poor-mouthing, the Department of Health has been bleeding hundreds of millions to cover people who don’t even live here. Only a few months ago, the legislature had a special session about the fabled ‘fiscal cliff’ unicorn that no one has ever seen. Those trigger words evoke enough fear that, like lemmings over a cliff, your Republican legislators voted nearly lock-step to foist a brand-new one-cent sales tax on you. They even broadened the base, so you’re now paying a new sales tax on your Netflix and Disney+ subscriptions (among other things).

We’ve been laying out a lot of stupid and wasteful spending lately. So far, my rough number on Sunday’s Senate amendment alone is well over $50 million. However, one simple bureaucratic fix on $103 million in unnecessary (and probably illegal) Medicaid expenses overshadows that.

Louisiana has the single highest sales tax in the nation, and number two isn’t even close. Our government’s response? You need to pay more so we can waste it on junk like this. So, we’re back to our original quote from Iago, that silly parrot from Aladdin. “That’s so incredible, I think I’m gonna have a heart attack and die from not surprise!”