(The Center Square) − On the final day of Louisiana’s legislative session, lawmakers from both chambers passed resolutions urging Congress to rethink proposed Medicaid cuts, warning that a sharp reduction in federal support would devastate the state’s health care system and trigger a special legislative session to plug a massive budget hole.

The move comes in response to a sweeping federal proposal — championed by former President Donald Trump and dubbed the “Big Beautiful Bill” — that seeks to slash federal Medicaid spending by billions of dollars.

According to Senate President Cameron Henry, Louisiana would lose some $4 billion.

“If we strictly went with what’s been proposed, I would not want to craft a state budget minus $4 billion,” Henry said. “We cannot handle a huge drop immediately. If this bill takes effect as written, we would absolutely have to come back into a special session. No doubt about it — and what we’d have to do wouldn’t be pleasant.”

Henry said he’s been in direct contact with U.S. Sen. Bill Cassidy, U.S. House Speaker Mike Johnson, and U.S. House Majority Leader Steve Scalise, all of whom represent Louisiana in Washington. He said those conversations have centered on finding a more gradual approach to Medicaid reform that avoids a cliff effect.

“I’m hoping we get some type of a two- or three-year implementation period with the ability to change things along the way,” Henry said. “I think that’d be the that’s the most realistic thing we can ask our delegation for.”

Rep. Vanessa LaFleur, D-East Baton Rouge, who sits on the House Appropriations Committee, echoed the concern.

“If it happens the way we anticipate, we’ll be back in special session. We’ll be making cuts. Because we have to,” LaFleur said.

The federal legislation, which has passed the U.S. House, would also impose work and reporting requirements on Medicaid expansion enrollees, repeal several Biden-era enrollment protections, and tighten rules around how states draw down federal Medicaid dollars.

More than half of the $427 billion in proposed savings would come from states like Louisiana that expanded Medicaid under the Affordable Care Act.

Henry said that Louisiana’s delegation was aware of the danger for rural hospitals.

“How can we move forward with the changes they want to make without devastating local hospitals, rural hospitals and so forth,” Henry said.