A few weeks ago, I learned that our friend, Ruth Kennedy, former LaCHIP and Medicaid Director in Louisiana, had passed away. I met Ruth back in the early 2000’s when we were both CHIP directors and participated in the Covering Kids and Covering Kids and Families grant programs funded by the Robert Wood Johnson Foundation. Soon after I joined the faculty at CCF, I had the pleasure of working more directly with Louisiana providing technical assistance under another RWJF program, Maximizing Enrollment.
Ruth was ahead of her time. She was formidable in her quest to make sure all Louisiana children had health coverage. She understood the importance of using data to remove red tape barriers to enrollment and renewal. She knew that culture change was an important aspect of managing Medicaid eligibility and consumer assistance. She sent her eligibility workers into the field for outreach events, so they could experience firsthand the barriers families face and appreciation they felt when their kids were insured.
When I say Ruth was ahead of her time – consider this:
In 2008, less than 1% of children enrolled in Louisiana’s LaCHIP program lost coverage at renewal due to procedural or administrative reasons.
Ruth always generously shared what she had learned with her colleagues across the country. We loved her “Ruth-isims” such as referring to having a hole in the bucket when the enrollment gains achieved through aggressive outreach and improving application procedures quickly disappear if eligible children lose coverage at renewal.
Ruth was one of the first health care leaders we featured on the Say Ahhh! Health Policy blog when we launched it in 2008. In that interview, Ruth generously shared tips on how to replicate Louisiana’s success connecting eligible children with coverage. One tip: “Empower managers and frontline employees by setting goals, allow them to use their common sense to achieve those goals, and listen to their suggestions for improvements. “
Louisiana lost a passionate, committed leader when Ruth retired in 2017 and her absence was evident in the renewal data. In December 2025, 20% of individuals were disenrolled at renewal – three-quarters of them (15%) were disenrolled for procedural or administrative reasons. The Louisiana experience demonstrates that focused, continuous, yet incremental change is important and requires a strong, consistent leader to keep pushing policies forward while tracking, reporting, and sharing retention data to measure the impact of each change.
So how did Louisiana achieve such spectacular results during Ruth’s tenure?
- Using data extensively to automatically determine ongoing eligibility at renewal
- Encouraging families to renew online or by phone to reduce paperwork
- Extending the renewal period when families provide updated information that reflects ongoing eligibility
- Aggressive follow-up by phone
- Requiring supervisory review to ensure that every effort was made to confirm eligibility prior to disenrolling a child
- Thinking outside of the box and implementing creative strategies.
The Louisiana Department of Health recognized Ruth’s achievements and contributions with a wonderful public statement and quote from Louisiana Department of Health Secretary Bruce Greenstein. “Ruth Kennedy was a trailblazer whose work changed the trajectory of health care in Louisiana. She was an extraordinary public servant and a tremendous colleague who challenged those around her to think bigger and do more for the people we serve. Her commitment and deep understanding of how policy affects real people set her apart. Generations of Louisianans have access to care because of her dedication.”
Ruth, we will always admire your leadership and spunk. Your legacy lives on among those of us committed to ensuring that every child in America gets the health care they need to grow up healthy and thrive.