(The Center Square) − In the legislative session’s final hours, Louisiana lawmakers called on Congress to halt sweeping federal Medicaid cuts and instead work with states to reform the program in a measured and collaborative way.
The resolution comes in response to the U.S. House’s passage of what President Donald Trump calls the “Big Beautiful Bill” and the intent to cut Medicaid spending by billions of dollars.
“Medicaid is a lifeline for more than 1.6 million people in Louisiana,” said Rep. Stephanie Berault, R-Slidell, in floor remarks. “Nearly seventy percent of our nursing home residents depend on it for long-term care, and more than half of all births in our state are covered by Medicaid. These cuts would hit us hard — especially in rural communities.”
The resolution warns that federal cuts would shift the burden of uncompensated care onto hospitals and providers, many of which already operate under significant financial constraints. Lawmakers emphasized that if changes to Medicaid are necessary, they must be targeted, evidence-based, and developed in close consultation with states.
“We’re not saying there shouldn’t be any reforms,” said Berault. “We’re saying: Don’t do it in a reckless way that throws vulnerable people off coverage and overwhelms our health care system. Work with the states to do it right.”
The House of Representatives has a distinct Louisiana flavor with Speaker Mike Johnson and House Majority Leader Steve Scalise both from the state.
The House-passed federal legislation includes provisions that would impose work and reporting requirements on adults covered under Medicaid expansion, roll back Biden-era rules streamlining enrollment, and restrict how states can finance their share of Medicaid costs.
More than half of the proposed federal savings — about $427 billion — would come from states that expanded Medicaid under the Affordable Care Act, including Louisiana.
During floor debate, Rep. Steven Jackson, D-Shreveport, asked how much of Medicaid costs are currently covered by the federal government. Berault responded that the federal match rate is 68% for Louisiana’s traditional Medicaid population and 90% for those covered under Medicaid expansion.
Jackson noted that when patients fall into uncompensated care, the federal government ends up covering the full cost.
In tandem with the resolution, the Legislature also approved reforms to the state’s Medical Assistance Programs Fraud Detection Fund.
Under Senate Bill 24, the state will expand the types of Medicaid-related recoveries deposited into the fund and prioritize funding the Attorney General’s Medicaid Fraud Control Unit and the Department of Health’s program integrity section. Any excess in the fund above $20 million will be directed back into the Medicaid program itself.
The resolution passed with seven members voting in opposition, all of whom were Republicans.
“I share the concern about potential cuts to Medicaid, and we call on Congress to not make the dramatic changes and to work with us for any savings that they want to find,” Berault said.
