Federalism and Policy Failure During Hurricane Katrina: Charity Hospital and the Displaced Uninsured

When Hurricane Katrina hit the Gulf Coast on August 29, 2005, close to 2,000 individuals lost their lives and the disaster cost the U.S. government $110 billion in damages, making Katrina the third deadliest and the most expensive hurricane in U.S. history. Katrina affected over 15 million people in seven states, but the most severe destruction occurred in Louisiana, Mississippi, and Alabama with the city of New Orleans, Louisiana bearing the worst of it.1 In addition to losing their homes, New Orleans residents lost access to health care services and to health insurance as a result of losing their jobs. This lack of coverage and care was especially challenging for the city’s most vulnerable residents including the poor, indigent, and chronically ill, many of whom lacked the resources to evacuate they city before Katrina made landfall. This paper explores what happened to these people when Charity Hospital, the state’s largest public health care facility closed following the storm, and asks whether federalism is partly to blame for the poorly coordinated response between municipal, state, and federal government officials.

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