• Work Requirements: The bill introduces work requirements for childless adults aged 19 to 64, mandating 80 hours per month of work, education, or volunteering to maintain Medicaid coverage. The Congressional Budget Office (CBO) estimates this could lead to 4.8 million additional people becoming uninsured by 2034, with $344 billion in federal savings over 10 years, per KFF analysis. Critics argue this targets “able-bodied” adults but may disproportionately affect those with inconsistent work or bureaucratic hurdles, as seen in Arkansas’ past experiment where 70% of affected individuals were confused about reporting requirements.
• Eligibility and Verification: The bill includes provisions to block an estimated 1.4 million people—claimed to be illegal immigrants or those unable to verify citizenship or immigration status—from Medicaid. The White House asserts this removes “waste, fraud, and abuse” by ensuring benefits go only to eligible Americans. However, FactCheck.org and CBO clarify that these individuals are often enrolled in state-only programs, not federal Medicaid, suggesting the impact may be overstated or mischaracterized as a federal cut.
• Penalties on States: States providing health coverage to undocumented immigrants (e.g., 14 states and D.C.) face a reduction in the federal Medicaid match rate for ACA expansion populations from 90% to 80%, potentially shifting $92 billion in costs to states over 10 years if they maintain these programs. This could lead to 1.4 million losing coverage, per CBO, though it’s framed as a penalty rather than a direct cut to federal Medicaid.
• Frequent Redeterminations and Paperwork: The bill proposes more stringent eligibility checks every six months and removes streamlined enrollment rules, which could disenroll people due to administrative burdens. Estimates suggest 10.3 to 14.4 million could lose coverage over a decade, with critics like Vox highlighting past state experiences where paperwork traps led to significant losses (e.g., 18,000 in Arkansas).
• Other Provisions: Additional cuts include banning Medicaid coverage for gender transition services and increasing cost-sharing (e.g., $35 co-pays for some services), which could further reduce access. Total projected federal Medicaid spending reductions range from $793 billion to $880 billion over 10 years, according to KFF and various reports.

If that’s what’s in the bill, it wouldn’t seem like Louisiana’s budget would have a hole in it at all.

This state is currently faced with a labor shortage – at least, that’s what the employers we talk to tell us. They’re desperate for people, and not just for skilled employees. So a 20-hour-a-week work requirement for Medicaid should actually result in motivating able-bodied people to join the workforce and in so doing probably create tax revenue for the state on net. And if they would rather lose Medicaid than work, then fine – that’s money we don’t have to spend.

As for illegals enrolled in the program… is that happening here? If so, should we take a poll among the people of Louisiana to see whether they’re interested in their tax dollars paying for welfare for illegals? We’ve got a pretty good idea how that’ll turn out.

And where increased eligibility checks are concerned, this is something conservatives in Louisiana have been arguing in favor of for a long time. Having the feds mandate those checks isn’t a cut to Medicaid, it’s a cleaning of the rolls that reduces waste and fraud.

We don’t see how any of this should impact Louisiana’s budget. If the Medicaid program gets smaller and more efficient, so what?

But then we see this…

With federal lawmakers weighing cuts to Medicaid and Medicare, health care leaders in Louisiana are sounding the alarm, warning that reductions in funding could devastate access to care for hundreds of thousands of residents.

“We have serious concerns about not only the impact on patients in our community health centers, but the impacts in our state,” said Raegan A. Carter, director of health policy and governmental affairs at the Louisiana Primary Care Association (LPCA).

Federally Qualified Health Centers (FQHCs), which provide care regardless of a patient’s ability to pay, are at the heart of that concern. Carter said 60% of the roughly 503,000 patients seen at Louisiana’s FQHCs rely on Medicaid for coverage.

“These are individuals who often don’t have access to health care, whether because a provider isn’t nearby or because they don’t have Medicaid or health insurance,” Carter said. “If these cuts go through, the effects will be felt far and wide.”

One-third of Louisiana’s population relies on Medicaid, a fact Carter emphasized in explaining the human toll potential cuts could bring.

“That could be your neighbor, someone in your family, someone at your church, someone on your job, someone you met just today,” she said.

Riiiight. And now you see what’s really going on.

The FQHC’s are the outpatient clinics for Medicaid patients. They don’t just see Medicaid patients, but it’s as much as a majority of their clientele. And Medicaid is like a one-stop shop for their billing.

The hospital emergency rooms, which are the other places Medicaid patients go, and particularly hospitals like Our Lady of the Lake in Baton Rouge, which has a contract with the state to provide indigent care, are also squawking about this.

Most private health clinics and individual doctors want nothing to do with Medicaid, because the reimbursement rates stink. That’s if you aren’t a bargain-basement doctor, of course.

So what we’ve got here is Cameron Henry hearing the squawking from Big Medicine that Trump’s Big Beautiful Bill might cramp their style and impose some discipline on Louisiana’s $19 billion Obamacare Medicaid behemoth, and he’s asking “how high?” to their command to jump.

And now you’ve got the state’s legacy media turning up the volume on a psyop against the people of Louisiana, demanding that if that $19 billion behemoth is to be put on a diet by the feds it has to be Louisiana’s taxpayers who fatten it back up.

And that brings us back to our first reaction.

You might consider contacting your legislator and telling them that you aren’t interested in a special session to provide funding for reinflating the Medicaid program once ineligible people, like whatever illegal aliens are in it, are removed. Because the hospitals and the Medicaid clinics will absolutely be on the horn demanding that trough be refilled.