Louisiana's Medicaid expansion enrollment has topped 400,000, as the future of the federal health care law that provides for the program remains unclear.

The Louisiana Department of Health announced on Thursday that enrollment is at 400,635 new enrollees.

The state had earlier placed its goal at about 375,000 enrollees by June 30. Because enrollment has outpaced the modest expectations set, it's now on track to reach nearly 450,000 in that time.

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“We’re seeing a generational shift in health care for Louisiana residents,” Dr. Rebekah Gee, secretary of the Louisiana Department of Health, said in a news release. “As more and more residents receive health care coverage and have access to regular and cost-effective primary care, fewer residents have to rely on expensive emergency rooms for their health needs. Medicaid expansion is creating better access to health care and saving taxpayer dollars at the same time.”

A recent Gallup report found the uninsured rate in Louisiana fell by nearly half from 21.7 percent in 2013 to 12.5 percent in 2016. The most recent Louisiana Health Insurance Survey which placed one in five adults here without health care coverage in figures just before expansion took effect suggests that much of that decline came after expansion began July 1.

“The primary goal for Medicaid expansion was to ensure that more Louisiana residents had access to health care coverage and access to health care services," Gov. John Bel Edwards said. "This report is conclusive proof that expansion is working.”

Medicaid expansion faces an uncertain future, so it's unclear how the new enrollees could be affected down the road. President Donald Trump and Republicans in Congress have vowed to repeal and replace the federal Affordable Care Act but have not yet revealed the terms of the replacement plan.

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According to stats from LDH, more than 58,700 adults have now received at least one preventive or primary care service after enrolling in the expansion. Sixty-seven women have been newly diagnosed with breast cancer, and 1,193 adults newly diagnosed with diabetes, among other outcomes cited.

Michele Kidd Sutton, president and CEO of North Oaks Health System in Hammond, said in the LDH release that the hospital has seen a 60 percent increase in mammograms for Medicaid patients, 61 percent increase in bone density screenings and a 26 percent increase in cervical cancer screenings.

"These are all real people, with real needs, who have had their lives changed for the better,” she said.