Healthcare coverage by one of the state’s four remaining Medicaid insurers is in question due to a contract dispute between the insurer and the state’s largest health system, health officials said Monday.

Louisiana Healthcare Connections is one of four plans currently slated to provide Medicaid coverage in Louisiana next year. But in June, the company told Ochsner Health it plans to end its contract with the health system effective Dec. 1, according to a recent letter Ochsner sent to Louisiana Department of Health Medicaid Director Seth Gold.

Without Ochsner providers in network, Louisiana Healthcare Connections could fall short of network adequacy standards, government requirements that insurers cover enough doctors and hospitals for patients, Gold said Monday.

The contract dispute and uncertainty about the Medicaid plan’s future come after two of Louisiana’s other Medicaid insurers announced within the last 12 months that they will no longer provide coverage in the state.

Healthy Blue, owned by parent company Elevance, decided this year to leave Louisiana’s Medicaid market effective Jan. 1. The company has not said why it is ending services here, though Elevance reportedly announced this summer that it planned to downsize its Medicaid business in a number of states due to weak profit margins.

And in December 2025, Louisiana did not renew its Medicaid contract with United Healthcare after Attorney General Liz Murrill clashed with the insurer over its pharmacy benefit manager, OptumRx.

Now, starting in January, four insurers are on track to offer Medicaid plans in Louisiana, down from six last year.

As of August, 1.2 million people are enrolled in Healthy Louisiana, the state’s Medicaid program, which provides health insurance to poor and disabled people. Of those, roughly 357,000 are insured through Louisiana Healthcare Connections.

What we know about the contract dispute

It is unclear why Louisiana Healthcare Connections, owned by parent company Centene, and Ochsner have not reached an agreement.

Louisiana Healthcare Connections did not respond to a request for comment.

Ochsner provided a statement but did not answer questions about what is causing the disagreement.

“As the largest provider of Medicaid services across the state of Louisiana, our focus is always on supporting the health and well-being of the people and communities we serve,” Ochsner’s statement said. “We work closely with state leaders toward that shared goal. As part of that ongoing collaboration, we recently provided LDH with an update on our provider network agreement with Louisiana Healthcare Connections. By being proactive and forthcoming about the status of those discussions, our goal is to help ensure Medicaid beneficiaries have clear information and can continue receiving the care they need without disruption.”

In a letter dated Oct. 9 to the Health Department, Ochsner said that since June it has “continued good-faith negotiations to reach an agreement and avoid disrupting care for LHCC members.”

“The potential impact on patients is significant. Ochsner serves more than 70,000 LHCC patients each year,” the letter says.

In a Sept. 22 news release, Louisiana Healthcare Connections said contract negotiations were ongoing at that time.

“The current agreements are approximately 15 years old,” the news release said. “In the years since they were established, health care delivery, technology and expectations for collaboration between health plans and providers have evolved considerably. Louisiana Healthcare Connections believes its partnership with Ochsner should evolve as well.”

State Sen. Patrick McMath, R-Covington, mentioned the impasse during a Senate health committee meeting on Monday, calling the stalled agreement “very concerning.”

In an interview, McMath said he wants to be sure Medicaid beneficiaries across the state have coverage, especially as Louisiana is on track to drop to four Medicaid plans. He said he’s hopeful the companies will resolve their differences.

“When there’s a disagreement with the largest health system in the state, Ochsner, that has 70,000 Louisiana Healthcare Connections patients, we’re gonna be paying to how those negotiations are going,” he said.

Gold, the Medicaid director, noted that “failure to reach an agreement would lead to Ochsner no longer being in network for LHCC starting December 1.”

He said the Health Department will ensure LHCC meets the state’s standards for patients’ access to care.

“We’re continuing to run the network adequacy reviews to make sure that they can meet that with or without Ochsner,” he said.