We are seeing, in very real terms, what happens when Washington makes health care harder to afford.

Across Louisiana, more people are showing up at hospitals without insurance. Families who had coverage just months ago are now going without it because they simply cannot afford it anymore.

The numbers are troubling.

As The Times-Picayune | NOLA.com recently reported, Louisiana’s Affordable Care Act Marketplace enrollment fell from 264,790 in March 2025 to 195,759 in March 2026, a 26 percent decline. Citing an analysis of federal data by KFF, the newspaper reported that Louisiana suffered one of the largest percentage declines in the country.

Those are not just numbers on a spreadsheet. Those are people.

They are small-business owners, independent contractors, gig workers, early retirees, and working families who often find themselves caught in the middle. They may earn too much to qualify for Medicaid, but still cannot afford the full cost of private health insurance.

I have heard from hospitals and health care providers across Louisiana, and their concern is real.

My position is pretty straightforward. If there is fraud, prosecute it. If someone is abusing the system, stop it. We have a responsibility to protect taxpayer dollars.

But we should not confuse fighting fraud with taking affordable health coverage away from people who legitimately need it.

Many families simply got priced out.

We warned that this would happen. We warned that allowing these tax credits to expire would force working families off their health insurance and put greater pressure on hospitals and emergency rooms. Those warnings were dismissed, and President Trump and his allies in Congress moved forward anyway.

Now we are living with the consequences. And unfortunately, the people paying the price are not the politicians who made these choices. They are Louisiana families.

When someone loses insurance, the illness does not disappear. The diabetes is still there. The heart condition is still there. The prescription still needs to be filled.

What changes is when that person gets care.

People wait longer to see a doctor. They stretch prescriptions. They put off routine care. And too often, a condition that could have been managed early becomes an emergency.

That is worse for the patient and more expensive for all of us.

The Times-Picayune | NOLA.com reported that Baton Rouge General has seen roughly 3,000 additional uninsured patients. Other health care providers around Louisiana are feeling the pressure as well.

That should concern all of us.

Hospitals cannot make the cost of treating uninsured patients disappear. Somebody ultimately pays, whether it is the hospital, taxpayers, other patients, or the health care system as a whole.

And there may be more trouble ahead. According to KFF data cited in the newspaper’s reporting, ACA insurers are seeking premium increases averaging roughly 15 percent for 2027.

Think about what that means for a family already dealing with higher grocery bills, housing costs, utilities, and child care. Another big increase in health insurance may simply be more than the family budget can take.

This is where our priorities in Washington deserve some serious scrutiny.

We somehow find billions of dollars for wars, major construction projects, reflecting pools, lavish renovations, and remaking parts of the White House. But when the conversation turns to helping working Americans keep their health insurance, suddenly we are told we cannot afford it.

I do not accept that.

America is strong enough to protect our interests abroad and take care of our people here at home. We can do both.

So where do we go from here?

We have work to do, and I intend to keep doing my part.

We must restore the enhanced premium tax credits that helped working families afford coverage. We must protect Medicaid for the people who depend on it and strengthen the hospitals, community health centers, and other providers being asked to carry a heavier burden.

We must keep working to lower prescription drug costs and demand greater transparency and accountability when insurance premiums rise.

And yes, we must aggressively fight fraud, waste, and abuse wherever it exists. I will gladly work across the aisle to do that.

But fighting fraud cannot become an excuse for pricing honest, hardworking people out of health care. We can protect taxpayers without abandoning families who are doing everything right and simply cannot afford another increase.

I will continue working with my colleagues, Democrats and Republicans alike, to find a responsible path forward. Health care cannot become just another partisan talking point while Louisiana families and Louisiana hospitals are dealing with the consequences in real time.

Those of us who serve in Washington also have to be accountable to the people who sent us there.

Ask us how we voted.

Ask what we fought for.

Ask whether the policies we supported made your health care more affordable or less affordable.

And ask what we are doing now to fix it.

Then remember those answers when you vote.

I accept that accountability. Every elected official should.

Because behind every statistic is a person. A father trying to keep his family insured. A small-business owner watching another bill go up. An older worker who is not yet eligible for Medicare. A hospital treating another uninsured patient because that person still needs care, insurance card or not.

We can change this.

We can restore affordable coverage, protect Medicaid, lower prescription drug costs, support our hospitals, and fight real fraud without punishing honest people.

That is the work before us.

I am ready to do my part and ready to push others to do theirs.

Now we need the political will, on both sides of the aisle, to get it done.

Congressman Troy A. Carter, Sr.

Louisiana’s 2nd Congressional District