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More than 70 Million Americans Are on Medicaid. This Is Where They Live.

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More than 70 Million Americans Are on Medicaid. This Is Where They Live.

In the stretch of rural Kentucky that borders West Virginia, voters reliably send Republicans to Congress. Representative Hal Rogers, who represents the area, did not even face a Democratic challenger in 2024. More than 40 percent of the population there relies on Medicaid, the public health insurance plan for low-income Americans.

In eastern Louisiana, where Representative Julia Letlow, a Republican, was elected in 2024 by a wide margin, about one-third of the population is enrolled in the program.

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Share of population enrolled in Medicaid

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Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming have not adopted the Affordable Care Act’s Medicaid expansion.

The New York Times

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And in California’s Central Valley, Republicans control a district where two-thirds of the population is on Medicaid, one of the highest rates in the nation, according to an analysis of federal enrollment data by the Center on Budget and Policy Priorities, a liberal think tank.

Some of those places could bear the brunt of steep Medicaid cuts that are expected to be central to Republicans’ budget plans. The budget passed on Tuesday night by House Republicans directs Energy and Commerce, the committee that oversees Medicaid, to cut spending by $880 billion over the next decade, which would amount to an 11 percent reduction in the program’s planned spending.

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In its 60 years, Medicaid has swelled from a small program that provided medical care to poor Americans receiving cash assistance to the largest source of public insurance. It covers 72 million Americans, about one-fifth of the population. It pays for about half of all nursing care in the United States, and 40 percent of all births.

The program has grown especially quickly over the last 15 years, as millions joined through the expansion of the Affordable Care Act to cover healthy adults who earn less than 138 percent of the federal poverty line, about $21,597 for an individual and $36,777 for a family of three. The rolls swelled again during the coronavirus pandemic, when Medicaid extended emergency coverage to millions.

Republicans have not yet specified what policy changes they would make to Medicaid. Options discussed include requiring enrollees to be employed, or dialing down funding for the Affordable Care Act’s expansion, which made millions of adults eligible for coverage. A work requirement would be expected to cut Medicaid spending by about $100 billion over the next decade, as those unable to comply — or to file the correct paperwork showing their employment — would lose coverage.

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In a statement, Representative Rogers of Kentucky described claims his party would gut the program as “lies promoted by House Democrats.”

“We are on a mission to cut waste, fraud and abuse of taxpayer dollars, so that we can protect the future of programs like Medicaid for years to come,” he said.

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Medicaid enrollment rates, by congressional district

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Large cuts to Medicaid would likely hit dense urban areas that tend to vote for Democrats. The congressional district that covers part of the Bronx in New York, for example, has one of the highest Medicaid enrollment rates in the country, with the program covering 67 percent of the people who live there. A district that covers part of Los Angeles has more than half its residents enrolled in the program.

Of the 10 congressional districts with the highest share of residents enrolled in Medicaid, nine are held by Democratic legislators.

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Districts with the highest Medicaid enrollment rates

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Note: Margin of victory not shown for representatives who faced another member of the same party on the November ballot.

There are also pockets of the country that rely significantly on the program where voters favor Republicans. Of the 218 seats Republicans control in Congress, 26 are in districts where Medicaid covers more than 30 percent of the population, according to a New York Times analysis of federal enrollment data.

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All 26 of those representatives voted in favor of the House budget this week.

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Republican districts with highest Medicaid enrollment rates

Note: Margin of victory not shown for Republican representatives who faced another Republican on the November ballot.

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Their districts are scattered across the country, from Alaska to West Virginia. The list includes the Louisiana district held by Speaker Mike Johnson, where 33 percent of residents are enrolled. All are in states that participate in the Medicaid expansion. Republicans have considered scaling back funding for that program, which would save the federal government about $500 billion over the next decade — but also leave people in many states without coverage.

While President Trump has repeatedly said over the last week he would not cut Medicaid, Republican legislators don’t have many options for looking for those cuts elsewhere. Some have already expressed concern about cuts to the program. Last week, seven Republican members of the Congressional Hispanic Conference sent Speaker Johnson a letter warning that “slashing Medicaid would have serious consequences, particularly in rural and predominantly Hispanic communities.”

As the second Trump administration has gotten underway, health care has not been a top issue for the president’s voters. It ranked as the fifth-most-important issue to them in a January poll from The New York Times and Ipsos, behind immigration, the economy, inflation and taxes.

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In January, Michael Perry, a founder of the polling firm PerryUndem, conducted three focus groups with Medicaid enrollees who voted for President Trump, noting that most did not list health care among their top voting issues.

When he brought up the idea that Republicans were exploring cuts to Medicare, some said they did not think the president would ultimately cut their health coverage because he would want to avoid a backlash. But other voters, he said, expressed concern. “They liked Medicaid, said it made a difference in their lives,” Mr. Perry said. “It wasn’t hard for them to put their finger on what Medicaid had done.”

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Video: Trump Boasts About Economy in Prime Time Speech

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Video: Trump Boasts About Economy in Prime Time Speech

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Trump Boasts About Economy in Prime Time Speech

The president gave a televised speech that featured repeated criticism of Democrats and his predecessor, Joseph R. Biden Jr., along with boasts about gains that many Americans have said they are not experiencing.

Good evening, America. Eleven months ago, I inherited a mess, and I’m fixing it. The last administration and their allies in Congress looted our treasury for trillions of dollars, driving up prices and everything at levels never seen before. I am bringing those high prices down. It’s not done yet, but boy, are we making progress. Nobody can believe what’s going on. Here are just some of the efforts that we have underway. You will see in your wallets and bank accounts in the new year, after years of record setting falling incomes, our policies are boosting take-home pay at a historic pace. Next year, you will also see the results of the largest tax cuts in American history that were really accomplished through our great, Big Beautiful Bill. Military service members will receive a special, we call, “warrior dividend,” before Christmas, a “warrior dividend,” in honor of our nation’s founding in 1776. And the checks are already on the way. We are respected again like we have never been respected before. To each and every one of you, have a merry Christmas and a happy new year. God bless you all.

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The president gave a televised speech that featured repeated criticism of Democrats and his predecessor, Joseph R. Biden Jr., along with boasts about gains that many Americans have said they are not experiencing.

By Shawn Paik

December 18, 2025

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Texas Republicans launch ‘Sharia Free America Caucus’ aimed at defending ‘Western civilization’

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Texas Republicans launch ‘Sharia Free America Caucus’ aimed at defending ‘Western civilization’

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FIRST ON FOX: A pair of conservative lawmakers are launching a new group in the House of Representatives to “protect Western civilization in the United States,” according to one of its founders.

Reps. Keith Self, R-Texas, and Chip Roy, R-Texas, are starting the “Sharia Free America Caucus,” Fox News Digital learned first.

“Anytime you go to a fight, you bring as many friends with you as you can. I’m a military guy,” Self told Fox News Digital. “So what we need to do is build this caucus now so that we can start educating the American people to the dangers of Sharia in the United States.”

TRUMP MOVES AGAINST MUSLIM BROTHERHOOD AS ISLAMIST GROUP SPREADS IN WEST

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Reps. Chip Roy and Keith Self are creating a new group called the “Sharia Free America Caucus.” (Tom Brenner/Getty Images; Andrew Harnik/Getty Images)

Self said it was “fundamentally incompatible with the U.S. Constitution.”

The caucus also has support in the Senate from Sen. Tommy Tuberville, R-Ala., who Self said he hoped could help push some of its legislative goals forward through both chambers.

Among the bills they’re hoping to push is a ban on foreign nationals who “adhere to Sharia” from entering the U.S., and a measure that would designate the Muslim Brotherhood as a terrorist organization.

FORMER UK PM DEFENDS TRUMP FOR HIGHLIGHTING ‘SHARIA LAW’ IN BRITAIN DURING UN SPEECH

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Sen. Tommy Tuberville arrives for a Senate Republican Caucus luncheon at the U.S. Capitol in Washington, April 2, 2025 (Nathan Posner/Anadolu via Getty Images)

“America is facing a threat that directly attacks our Constitution and our Western values: the spread of Sharia law,” Roy said in a statement. “From Texas to every state in this constitutional republic, instances of Sharia adherents masquerading as ‘refugees’ — and in many cases, sleeper cells connected to terrorist organizations — are threatening the American way of life.”

Sharia broadly refers to a code of ethics and conduct used by devout Muslims. Sharia law more specifically often refers to the criminal code used in non-secular Islamic countries, like Iran.

In its most extreme cases, such as when ISIS-controlled parts of the Middle East, charges like blasphemy could carry the death penalty.

U.S. Capitol building is seen in Washington, Dec. 2, 2024.  (Celal Gunes/Anadolu via Getty Images)

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But guarantees of religious freedom in the Constitution mean that Sharia law can not be carried out on any governmental level in the U.S.

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The Republicans’ caucus appears largely symbolic in nature, but it’s evidence of the continued culture war raging in the country.

Self also pointed to countries like the U.K. and France, where growing unrest between Muslim refugees and the current populace has dominated headlines in recent years.

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Who’s running the LAPD? Chief’s style draws mixed reviews in first year

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Who’s running the LAPD? Chief’s style draws mixed reviews in first year

When an LAPD captain stood up during a meeting this fall and asked Chief Jim McDonnell to explain the role of his most trusted deputy, Dominic Choi, other top brass in attendance waited with anticipation for the reply.

Multiple department sources, who requested anonymity to discuss the private meeting and speak candidly about their boss, said McDonnell’s answer drew confused looks.

Some officials had began to wonder how closely the 66-year-old McDonnell, who stepped into the job in November 2024 after recent work in consulting and academia, was involved in day-to-day operations. Choi is often attached to his hip, and McDonnell has privately advised other senior staff to go through the assistant chief for key matters, leaving some uncertainty about how shots are called, the sources said.

At the senior staff meeting, McDonnell joked about not wanting to talk about Choi — who was not present in the room — behind his back, and told the captain that Choi was simply his “eyes and ears,” without offering more clarity, according to the sources.

The awkward exchange reflected the uncertainty that some LAPD officials feel about McDonnell’s leadership style.

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Over the last year, The Times spoke with numerous sources, from high-ranking commanders to beat cops on the street, along with recently retired LAPD officials and longtime department observers, to gather insights on McDonnell’s first 12 months as the city’s top cop.

By some measures, McDonnell has been a success. Violent crime citywide has continued to decline. Despite the LAPD’s hiring struggles, officials say that applications by new recruits have been increasing. And support for the chief remains strong in some political circles, where backers lauded his ability to navigate so many challenges, most not of his own making — from the city’s financial crisis and civil unrest to the devastating wildfires that hit just two months after he was sworn in.

At the same time, shootings by police officers have increased to their highest levels in nearly a decade and the LAPD’s tactics at protests this summer drew both public outrage and lawsuits. Some longtime observers worry the department is sliding back into a defiant culture of past eras.

“You’ve got a department that’s going to bankrupt the city but doesn’t want to answer for what it is going to be doing,” said Connie Rice, a civil rights attorney.

In an interview with The Times, McDonnell said he is proud of how his department has performed. He said his bigger plans for the LAPD are slowly coming together.

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McDonnell rose through the LAPD’s ranks early in his career, and acknowledged much has changed in the 14 years that he was away from the department. That’s why he has leaned “heavily” on the expertise of Choi, who served as interim chief before he took over, he said.

“He’s been a tremendous partner for me coming back,” McDonnell said.

Dominic Choi, who served as interim LAPD chief before Jim McDonnell was hired, speaks at a 2024 news conference with federal law enforcement officials.

(Al Seib / For The Times)

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McDonnell added that he has relied just as much on his other command staff, encouraging them to think and act for themselves “to get the job done.”

Retired LAPD commander Lillian Carranza is among those saying the new chief has failed to shake things up after Michel Moore stepped down abruptly in January 2024.

Instead, she said, McDonnell has lacked the decisiveness required to make real changes in the face of resistance from the police union and others.

“It appears that the chief thought he was coming back to the LAPD from 15 years ago,” she said of McDonnell. “It’s been a disappointment because of the individuals that he’s promoted — it just seems like Michel Moore 2.0 again.”

There are notable contrasts in style and strategy between McDonnell and his predecessor.

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Moore, who did not respond to a call seeking comment, often used his pulpit to try to get out ahead of potential crises. McDonnell has kept a lower profile. He has largely halted the regular press briefings that Moore once used to answer questions about critical incidents and occasionally opine on national issues.

Unlike Moore, who developed a reputation as a demanding manager who insisted on approving even minor decisions, McDonnell has seemingly embraced delegation. Still, his perceived deference to Choi, who also served as a top advisor to Moore, has led to questions about just how much has really changed. Choi has represented the department at nearly a fourth of all Police Commission meetings this year, a task usually performed by the chief.

Former LAPD Chief Michel Moore

Former LAPD Chief Michel Moore attends an event at the Police Academy on Dec. 7, 2023.

(Irfan Khan / Los Angeles Times)

It’s telling of their closeness, LAPD insiders said, that Choi occupies the only other suite on the 10th floor of LAPD headquarters with direct access, via a balcony, to McDonnell’s own office.

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Choi did not respond to a request for comment.

Mayor Karen Bass chose McDonnell as chief after a lengthy nationwide search, picking him over candidates who would have been the first Black woman or first Latino to lead the department. He offered experience, having also served as police chief in Long Beach and as L.A. County sheriff.

McDonnell has mostly avoided the type of headline-grabbing scandals that plagued the department under Moore. Meanwhile, homicides citywide were on pace to reach a 60-year low — a fact that the mayor has repeatedly touted as her reelection campaign kicks into gear.

In a brief statement, the mayor commended McDonnell and said she looked forward to working with him to make the city safer “while addressing concerns about police interaction with the public and press.”

Jim McDonnell and Karen Bass shake hands

Jim McDonnell shakes hands with Mayor Karen Bass after being introduced as LAPD chief during a news conference at City Hall on Oct. 4, 2024.

(Ringo Chiu / For The Times)

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McDonnell has taken steps to streamline the LAPD’s operations, including folding the department’s four homicide bureaus into the Robbery-Homicide Division and updating the department’s patrol plan to account for the department being down fewer officers.

John Lee, who chairs the City Council’s public safety committee, said the chief is the kind of experienced and steady leader the city needs as it gets ready to host the World Cup and Olympics. McDonnell, he said, deserves credit for guiding the LAPD through “unprecedented situations,” while largely delivering on promises to reduce crime and lift officer morale.

But among the rank and file, there is continued frustration with the department’s disciplinary system. The process, which critics outside the LAPD say rarely holds officers accountable, is seen internally as having a double standard that leads to harsh punishments for regular cops and slaps on the wrist for higher-ranking officials. Efforts at reform have repeatedly stalled in recent years.

McDonnell told The Times that officers have for years felt that the system was stacked against them. One of his priorities is “making the disciplinary system more fair in the eyes of those involved in it,” he said, and speeding up internal affairs investigations that can drag on for a year or more without “jeopardizing accountability or transparency.”

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He said he’d like to give supervisors greater authority to quickly weed out complaints that “are demonstrably false on their face” based on body camera footage and other evidence.”

But the lack of progress on the issue has started to rankle the Los Angeles Police Protective League, the union for officers below the rank of lieutenant. The League urged McDonnell to take action in a statement to The Times.

“The way we see it, the Chief is either going to leverage his mandate and implement change, much to the chagrin of some in his command staff that staunchly support the status quo, or he will circle the wagons around the current system and continue to run out the clock,” the statement read. ”There’s no need to keep booking conference rooms to meet and talk about ‘fixing discipline,’ it’s time to fish or cut bait.”

Perhaps more than anything, the ongoing federal immigration crackdown has shaped McDonnell’s first year as chief.

Although McDonnell is limited in what he can do in the face of raids by Immigration and Customs Enforcement and other federal agencies, some of the chief’s detractors say he is missing a moment to improve relations between police and citizens of a majority-Latino city.

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The son of Irish immigrants from Boston, McDonnell drew criticism during President Trump’s first term when, as L.A. County sheriff, he allowed ICE agents access to the nation’s largest jail. As LAPD chief, McDonnell has often voiced his support for long-standing policies that restrict cooperation on civil immigration enforcement and limit what officers can ask members of the public about their status in the country.

“I get hate mail from two extremes: those that are saying we’re not doing enough to work with ICE and those that are saying we’re working with ICE too much,” McDonnell said.

Gregory Bovino surrounded by agents

U.S. Border Patrol Cmdr. Gregory Bovino marches with federal agents to the Edward R. Roybal Federal Building on Aug. 14.

(Carlin Stiehl / Los Angeles Times)

Deputy Chief Alan Hamilton, who runs the department’s detective bureau, said McDonnell has to tread lightly politically and can’t follow the suggestion of some people that “we should use our law enforcement agencies to fight back against the feds.”

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“He can’t come out and say, ‘We oppose ICE, get out of our city,’ like some of these other clowns are doing,” Hamilton said. “I mean, what, are you just trying to bring the wrath?”

But the LAPD’s response to the protests against Trump’s agenda has repeatedly led to bad optics. Officers have stepped in to keep the peace when angry crowds form at the scene of ICE arrests, which some said created the appearance of defending the federal actions.

During large demonstrations — which have occasionally turned unruly, with bricks and Molotov cocktails hurled by some in the crowds — LAPD officers on foot or horseback have not held back in swinging batons, firing less-lethal munitions and even launching tear gas, a measure that hadn’t been deployed on the streets of L.A. in decades.

Press rights organizations and a growing list of people who say they were injured by police have filed lawsuits, potentially adding to the tens of millions in the legal bills the department already faces for protest-related litigation from years that predated McDonnell.

Attorney Susan Seager, who is suing the department over its recent protest tactics, said that McDonnell has seemed unwilling to second-guess officers, even when confronted with clear video evidence of them violating court-imposed restrictions.

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“I’ve never seen LAPD so unhinged at a protest shooting people,” she said.

LAPD officer pushes back an anti-ICE protester

An LAPD officer pushes back an anti-ICE protester during a rally on “No Kings Day” in downtown Los Angeles on June 14.

(Carlin Stiehl / Los Angeles Times)

McDonnell said that each use of force would be investigated thoroughly, and if necessary discipline would be imposed, but denied that his department’s response had been excessive.

What goes unmentioned by the LAPD’s detractors, he said, is how volatile and “kinetic,” protests have been, requiring officers to use all means available to them to avoid being overwhelmed by hostile crowds.

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Reporters and others on the front lines should know the risks of being there, he said.

“If the journalists are in that environment, they sometimes get hit with less-lethal projectiles — as do our police officers who are in that same environment,” he said.

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