LA. – Few countries endure losing much from the megaville that President Donald Trump signed the law like Louisiana.
Louisiana is more poverty and sick than most of the country, and relies heavily on Medicaid benefits on those who lack the means to cover their own doctor visits.
That vulnerable lifeline is now at risk.
The “big beautiful bill” that Trump has become muscular through Congress will chop nearly a trillion dollars on Medicaid spending over the next decade.
From pure self-interest, Louisiana may seem like a nation fighting to maintain Medicaid. Approximately 35% of Louisiana under the age of 65 were covered by Medicaid in 2023, but recent data was available. The figure is the second highest among 50 states, according to KFF, a nonpartisan health policy organisation.
The state voted heavily for Trump in the 2024 election, and the voting show is grateful for the work he is doing as president.
Louisiana loves Trump, but they need Medicaid. How do deep red state adjust the two?
Interviews with mostly Trump-pro-Trump Louisiana suggest that many of the states have absorbed the argument that Trump and his Congressional allies used the bill to sell. Several warning signs of Trump appeared. Some of his voters are either unexcited or skeptical of what they describe as his big explosion, and this measure responds to its epic title.
“He’s a Jacka – he’s the Jacka – he’s the Jacka – we have,” said 56-year-old Jason Carl. She wears a shirt decorated like an American flag at the July 4th celebration in Mandeville, on the north shore of Lake Pontchartrain.
“A lot of times he says things we think, but don’t want to say anything out loud,” said Lydia Derouen, a customer of Cat’s Coffee and Creamery in Derrider, Louisiana, on a recent morning.
The embrace of the nation’s new law refers to the dynamic that prevailed in the Trump era. If he says he wants something, that’s enough for many of his voters.
“I’m just supporting President Trump, and most of what he’s doing, I’m working on that,” said Sue Armand, a 65-year-old retired man who attended a recent festival in Walker’s park, a city outside the state capital of Baton Rouge.
Nationally, the law will reduce the number of people receiving Medicaid in the next decade by nearly 12 million. This is the biggest cut since President Lyndon Johnson created the program 60 years ago as part of his “great society” agenda.
Some of the bill’s provisions require that people between the ages of 19 and 64 work at least 20 hours a week, unless they are caring for their children or are disabled. The bill also limits the ability to raise certain taxes to help pay for shares in state Medicaid programs, which could result in a complete cut.
Real-world outcomes can prove dramatic.
“Many people who were affected most negatively are Trump voters,” said New Orleans-based voter Cyrus Lee.
“We are in various parts of the country where many other communities that have supported Trump experience severe cuts in services that are essential to survival,” added Lee.
Alyssa Custard of New Orleans worries that wider cuts to Medicaid funding will mean for her family. Her 88-year-old mother suffers from dementia and goes to an adult day care center in New Orleans.
Custard’s mother, who served most of her life as a kindergarten teacher, has little savings on retirement and is not enough to pay for long-term private home care.
Custard and her brother provided care on their own and were able to continue working for the adult day care program. But that funding could now be at risk with cuts to Medicaid.
“My mother was in the education system for 50 years and caring for other people’s children,” Custard said. “She paid for all this, and now when it’s time to reap the profits of what she’s paid for for a long time, you have this bill that will take this from her and all the other people.”
The topic used by supporters to pass the bill was that Medicaid is full of abuse and that the changes would expel unfair recipients from the role.
House speaker Mike Johnson, Center holds the vote total for one big beautiful bill act. KevinDietsch / Getty Images
House Speaker Mike Johnson is a Trump royalist who helped pilot the bill through Congress, representing a strip of western Louisiana where nearly 25% of adults under the age of 65 rely on Medicaid.
Johnson suggests that beneficiaries include healthy people who are “scamming the system” because they are not at work.
“There’s a moral element to what we do. And when you put young men to work, it’s good for them, it’s good for their dignity, it’s good for their self-worth, it’s good for their self-worth, it’s good for the community they live in,” he said in May.
That justification is true to many people in his hometown, and he believes that the interests of the federal government go to the wrong people more widely.
Jason Wallace (37), an accountant who sets up “Nibble and Noche” at the Walker Festival [the new law is that it is] We are trying to prevent tortillas from exploiting our profits that we have not paid at all. ”
A common belief is that taxpayers are being shortened and it is causing feelings of anxiety that Trump is somehow using it.
The new law also cuts down the food aid program known as SNAP. In addition to Medicaid, Congress has halted Snap’s profits and created savings that help offset the cost of extending the tax cuts Trump signed in his first term.
“You’re lined up, the woman in front of me is doing her nails, her hair, she’s got food stamps.
“People come to this country for no reason and get things they shouldn’t have,” he added.
Nancy Adams (I’m a single mother, I’m a daughter and I struggle every day, and yet these illegals come in and they get everything. But I’m struggling to raise my daughter.
Independent analysis of the Medicaid program shows that most recipients have already been adopted. In May, KFF released a report in 2023 showing that almost two-thirds of people receiving Medicaid under the age of 65 were not working fully or part-time in other forms of federal aid. Those who lacked work cited reasons including attendance at school, caregiving duties, illness, disability, or other causes.
Another KFF report from the month showed that while 95% of Medicaid payments last year were made appropriately, the majority of inappropriate payments came from paperwork errors or management measures.
Robin Rudwitz, director of KFF’s Medicaid and uninsured programs, estimates that 10 million people could lose health insurance coverage under the new law.
“These are not people who were cheated on the program,” she said.
Heading towards Derridar in the western part of the state, drivers are looking at signs advertising legal services for those who endure car destruction or injury or are bankrupt. Deridder, a city of about 10,000, is part of Johnson’s council district.
Walmart in the city was doing business last Sunday. Some customers of various ages used electric carts rather than walking. Outside the store, Don Heston, 41, who works in the oil and gas industry, describes Medicaid as a “great idea,” but “needs to do something serious.”
“A lot of people on it aren’t. You have people who have paid for it for the rest of their lives. They’re physically ruined. They can’t work anymore, they can’t get it.
While excluding people who are abusing the program may be a valuable goal, Medicaid advocates are worried that such accuracy will not be reduced. According to Keith Leaderman, CEO of Clover, an organization serving Alyssa Custard’s mother, those who really need help may get caught up in the purge.
“In Louisiana, many of the same solid supporters of the President are suffering as a result of this bill, especially in rural areas of our state, with many struggling individuals and families.
The Clover is braceed for severe cuts that could shut down adult daycare services completely, Leaderman added.
“When I think about people who are financially poor and struggling, a lot of people across our country think that they are doing something wrong and confuses me that they aren’t working hard enough, that they’re not working hard enough, that they’re shakkers trying to abuse the system,” he said.
“It couldn’t be far from the truth based on my first-hand experience with thousands of people in these positions. I have never seen people who work harder and work harder to get out of poverty than the people we serve or many others in our community.”
If medical centers that rely on Medicaid patients are forced to close, it will also affect patients with other forms of health insurance.
At David Raines Community Health Center in northwest Louisiana, which includes several clinics in the Johnson area, officials are preparing to cut services as they expect the number of health insurance patients to drop significantly as a result of changes to the bill.
“To say the least, it will be truly devastating to be able to continue to provide the level of access we currently offer for the patients we serve, for the rest of the community health centers as a whole,” White said. “I don’t know how it works.”
The act, which is registered on nearly 900 pages, involves policy changes that take time for voters across the country to digest. Trump instructed Republican lawmakers to hand it over by July 4th, and they followed. So far, most of this pro-tramp state appears to be happy with what they have done. But some of the people who voted for Trump were waiting and watching. They know that the new law is big. They still don’t know if it’s beautiful yet.
Jennifer Bonano, 52, is a retailer who came to the Walker festival. Sitting in a folding chair, she said she voted for Trump but hadn’t yet convinced the new law was all that was being promoted.
“We don’t want people who need Medicaid and who need food aid to suffer,” she said.
Regarding her vote back in November, she said: “I’m still wondering.”
“You don’t know yet what the outcome will be, because you don’t know when you’ll be still with Trump,” Bonano said. “I don’t know if that’s a good or a bad thing,” he says.
President Donald Trump signed “The Big, Beautiful Bill Act” at the White House on July 4th.
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