Medicaid is the backbone of maternal and child health in Louisiana. Nearly two-thirds of births in Louisiana are paid for by Medicaid and more than half of children are covered by Medicaid — among the highest rates in the country. But that lifeline is now in jeopardy following sweeping federal cuts to the program.
Congress recently passed a bill that will slash federal Medicaid funding by imposing work requirements and tightening eligibility. In Louisiana, 100,000 people — about 44% of current Medicaid enrollees — stand to lose coverage when these rules take effect in December 2026. Even though 69% of adults in Louisiana with Medicaid coverage are already working, many may still lose coverage due to red tape and burdensome reporting requirements.
Proponents claim these requirements will curb fraud and restore the “dignity of work.” In reality, states where work requirements were previously implemented did not have increases in employment. They did, however, lead to coverage losses and worse health outcomes.
To preserve current Medicaid coverage levels, Louisiana would need to increase its own Medicaid spending by 400% — a financial impossibility in a state already struggling to meet basic health care needs. Without a federal fix, Louisiana will face impossible trade-offs: raise taxes, cut education and infrastructure budgets or reduce Medicaid enrollment or services even further — all of which harm working families.
These cuts would fall hardest on pregnant women and young families. Louisiana already ranks 48th in maternal and child health outcomes and has one of the highest rates of maternal mortality in the U.S. Gutting Medicaid would turn a public health crisis into a catastrophe.
More than half of Louisiana parishes are considered maternity care deserts — places where obstetric care is absent or dangerously limited. Over a third have no obstetric provider or hospital unit at all. Medicaid cuts would force more rural hospitals to close or eliminate obstetric care entirely, leaving entire regions without providers for prenatal or postpartum care.
The consequences aren’t theoretical. A pregnant woman in rural Avoyelles Parish may soon have to travel even further than 30 minutes to her closest birth hospital. A mother in New Orleans East might forgo postpartum visits because she no longer qualifies for Medicaid under new eligibility rules.
This will be especially devastating for Black women in Louisiana, who are already 2.5 times more likely to die from pregnancy-related causes. These proposed cuts would deepen racial and geographic inequities and decimate care in the very communities that rely on it the most.
Louisiana policymakers must act swiftly to blunt the impact of these federal cuts. That includes maximizing state funding to preserve coverage for pregnant women and families, pursuing federal waivers to maintain access for vulnerable groups and minimizing red tape that could cause eligible residents to lose care. Leaders should also invest in community-based outreach and enrollment assistance to ensure families understand the new rules and don’t fall through the cracks. Doing nothing is not an option — the health of thousands of Louisiana women and children is on the line.
The bill may be signed, but the fight is far from over. State leaders must do everything in their power to shield Louisiana families from its worst effects. That starts with protecting, not slashing, Medicaid. Our health, our economy and our future depend on it.
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