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President Donald Trump’s budget bill cuts Medicaid. Here’s what it means for Louisiana.

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President Donald Trump’s budget bill cuts Medicaid. Here’s what it means for Louisiana.


WASHINGTON – During his nearly nine-hour floor speech opposing passage of the Republicans’ One Big Beautiful Bill Act, House Minority Leader Hakeem Jefferies used Louisiana to underscore his argument that the measure harms Medicaid.

The legislation, signed into law Friday, includes tax breaks and increased funding for Republican priorities. It pays for them, partially, by cutting spending by $1.1 trillion over the next 10 years for Medicaid and the Affordable Care Act.

That will lead to 17 million Americans losing healthcare coverage, according to the Congressional Budget Office.

“Louisiana is a state that stands to suffer mightily as a result of this all-out assault on Medicaid,” said Jefferies, D-Brooklyn. He pointed out that the Republican supermajority in the Louisiana Legislature passed a resolution asking Congress not to slash Medicaid because the state, one of the poorest in the nation, simply couldn’t afford the extra costs.

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Except for New Mexico, Louisiana has the nation’s highest percentage of residents — one third — on Medicaid, which covers the cost of healthcare for low-income adults, children and seniors. The law eventually could cost Louisiana $4 billion and lead to 267,550 losing their coverage over the next 10 years, according to the Kaiser Family Foundation and other nonpartisan experts.

However, in the frenzy of negotiations other the past few weeks, some of the biggest cuts were delayed for several years.

That includes some of the changes that most alarmed Louisiana health care leaders, such as new restrictions on provider taxes and state-directed payments.

Louisiana’s hospital community, while not exuberant, says the bill could have been much worse had the Louisiana congressional delegation not inserted wording that delayed the changes, said Paul A. Salles, president and CEO of the Baton Rouge-based Louisiana Hospital Association.

State Senate President Cameron Henry, R-Metairie, put it more succinctly in a post on X: “The Senate-passed reconciliation bill is much improved, and Louisiana is in good shape.”

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Henry had said a previous version of the bill could have caused a big enough budget problem for Louisiana that the Legislature would need to convene for a special session.

With some of the biggest changes still years out, some in Louisiana health care circles hope changes can be made to blunt the impact of the cuts. Many of those changes won’t take effect until after mid-term elections next year, when the makeup of Congress could change significantly.

How Medicaid could change in Louisiana

Of the $16.4 billion annual Medicaid costs for Louisiana, state taxpayers kick in about $3 billion, according to the Legislature. The new law would halt some of the tools Louisiana uses to pay that $3 billion, requiring the state to pour in extra money or let some people go without health insurance.

Republicans cast the changes as needed to shore up the healthcare programs by ensuring services remain available only for those truly in need.

“A lot of the estimations are far overblown … especially in my district,” said House Speaker Mike Johnson, R-Benton. About 40% of his constituents are Medicaid eligible.

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But U.S. Rep. Troy Carter, D-New Orleans, said the bill “represents the largest cuts to health care and nutrition assistance in American history. …It strips support from our hospitals and nursing homes,” threatening to close long-term facilities and rural hospitals. About 38% of Carter’s constituents are Medicaid eligible.

Much of the savings in the new law come from fees the state levies on hospitals, clinics and other healthcare providers. These provider taxes help the state put more money into Medicaid.

Provider taxes also have the effect of increasing the portion the federal government must pay. The new law ratchets down the provider tax rate from 6% to 4.5% over several years. But Louisiana’s rate is 4.6%, so the state has a buffer.

Some of the money raised through provider taxes goes directly to hospitals in what are called state directed payments. One state directed payment sends funds to rural hospitals whose patients – almost half in some parishes – have Medicaid, which doesn’t always cover the cost of services provided. 

The new law immediately freezes the size of state directed payments and, starting in 2028, lowers that amount by 10% each year.

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The provider tax also is used to boost Medicaid payments to nursing home facilities used by seniors who need long-term nursing care but have run out of insurance and savings, which is about 60% of them in Louisiana. The bill will effectively lower payments to nursing facilities and could cause many to limit patients or close their doors.

State directed programs using provider taxes, such as those for rural hospitals and nursing homes, must be approved by U.S. Centers for Medicare & Medicaid Services, called CMS.

Wording inserted by U.S. Sen. Bill Cassidy, R-Baton Rouge, allows CMS to consider Louisiana’s state directed payment applications already in the pipeline.

“It’s a small change with huge consequences,” Cassidy wrote in a memo to state officials.

As part of the deal to persuade senators to accept restrictions on provider taxes and state directed payments, the Senate created a $50 billion fund to help rural hospitals.

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Louisiana hospital officials say the fund will help but the amount is insufficient. But delaying until 2028 allows time for the provisions to be amended.

Work requirements

One of the biggest changes is a requirement that most adults under the age of 65 years work, volunteer or go to school at least 80 hours a month. The states will have to verify eligibility twice a year rather than every 12 months beginning in 2027.

KFF Health, a respected San Francisco-based nonpartisan health care thinktank, says relatively few people who receive Medicaid are able to work but choose not to.

KFF found that 69% of Louisiana Medicaid population is working and most of the 31% who are not working are disabled, elderly, or provide care for a sickened family member or are covered under the exemptions included in the law.

The issue with the work requirement, said U.S. Rep. Cleo Fields, is the amount of paperwork and effort required to remain qualified. States that have tried work requirements ended up forcing qualified recipients off Medicaid rolls.

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“It sounds good,” said Fields, D-Baton Rouge. But the data shows more people lose their qualifications from being unable to quickly track down the appropriate supporting documents, such as proof of previous jobs.

The Louisiana Department of Health, which will handle the increased vetting, did not respond to inquiries. But LDH officials told hospital and congressional representatives that a more technologically advanced system is being put in place to handle the qualification process more efficiently and will be ready by 2027, when those requirements go into effect

The new law also will charge a small co-pay to some enrollees, particularly those in families of four with incomes between $32,000 to $44,000 annually, for most provider visits except for primary care and some other services.

People who buy private insurance using federal subsidies under the Affordable Care Act will have to sign up during a narrower window from November 1 to December 15.

“For the first two years, we’ll be fine, but at some point that third year is going to come,” Fields said. About 37% of his constituents are Medicaid eligible.

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“It doesn’t negate the fact that soon people who use Medicaid are going to lose their healthcare benefits and many of the hospitals, particularly rural hospitals, will close,” he added.



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Neuty, the beloved Bucktown nutria rat that charmed Louisiana, has died

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Neuty, the beloved Bucktown nutria rat that charmed Louisiana, has died


Neuty, the iconic Bucktown nutria visits the state capitol, with Myra Lacoste, Denny Lacoste, Lieutenant Governor Billy Nungesser, Dennis Lacoste Sr., and Louisiana state Senator J. Cameron Henry Jr. Neuty was an orphan, rescued by the Lacostes. In March 2023, LDWF agents attempted to confiscate the illegal pet.  



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Louisiana State Police arrest 18-year-old in Vidalia crash t…

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Louisiana State Police arrest 18-year-old in Vidalia crash t…


VIDALIA, La. — Louisiana State Police arrested 18-year-old Gregory Steele early Sunday morning on two counts of vehicular homicide, one count of underage operating a motor vehicle while intoxicated, one count vehicular negligent injuring and one count careless operation, according to Concordia Parish Jail records.

Steele, 18, a white male, was arrested in connection with an accident that occurred at approximately 1:54 a.m. on Sunday morning on Minorca Road in Vidalia. Two passengers in the vehicle were killed. Steele and another passenger were able to escape the vehicle.



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On this Mother’s Day, three Louisiana mothers grieve the deaths of eight of their children, seven killed by their own father | CNN

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On this Mother’s Day, three Louisiana mothers grieve the deaths of eight of their children, seven killed by their own father | CNN


Christina Snow bends down and whispers something in her daughter’s ear as the 11-year-old lies in a white casket, eyes closed as if she were simply asleep.

On the morning before Mother’s Day, Sariahh Snow’s small, lifeless body is one of eight – all children – lined in open white caskets along the front of a church hall in Shreveport, Louisiana.

Except for the low murmur of church organ music drifting through the sanctuary, Snow’s muffled sobs momentarily silence an audience of hundreds who have gathered to grieve alongside the three mothers whose children were all fatally shot by the same man: the father of seven of the eight killed and an uncle to the eighth.

The shocking act of violence, which also left two of the mothers seriously wounded, marked the nation’s deadliest mass shooting in more than two years, a catastrophe so staggering it forced an already grief-stricken country to once again confront the deadly collision of a mental health crisis and America’s unrelenting access to guns.

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“This is not a Shreveport mourning,” Congressman Cleo Fields said in his tribute. “This is a nation mourning.”

Now remembered as the “Eternal 8,” Jayla Elkins, 3; Shayla Elkins, 5; Kayla Pugh, 6; Layla Pugh, 7; Mar’Kaydon Pugh, 10; Sariahh Snow, 11; Khedarrion Snow, 6; and Braylon Snow, 5, were killed in the April 19 shooting.

As grieving attendees lined up to pay respects to the children, one woman shut her eyes after peering at one of the children, Kayla, who wore a white dress, her fingernails carefully painted pink. Just behind her body stood a photograph from when she was still alive, her sweet, wide eyes impossible to reconcile with the stillness of the tiny body in the casket.

Inside the funeral pamphlet, Kayla is described by her family as “K-Mae,” a sweetheart with a big smile who never asked for much, but when she did, melted hearts. She loved “going to school, playing with her sisters, brothers, and cousins, and being outside running, jumping and even wrestling with those she loved.”

The seven other entries read as sweetly. Sarriah was described as “sunshine,” a creative, smart, and loving girl. Khedarrion loved helping his family and adored his principal. Braylon was sweet and gentle. Mar’Kaydon, or “K-Bug,” was a cheerful child who loved telling his grandmother what he learned at school every day. Jayla, also known as her family’s “little J-Bae,” taught her family “more about unconditional love, strength and resilience than words could ever express.” Shayla was warm and quiet. Layla adored her siblings and cousins so much she “would stand up for them no matter how big the other person was.”

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It’s a tragedy that sends chills racing down your spine and leaves a lump in your throat. Throughout the hall, people clung tightly to one another, wiping away each other’s tears. Children filled the pews — sweet, innocent and suddenly feeling even more precious to everyone there.

The Saturday funeral service was carried by the reverberating melody of gospel music that rattled through the hall like waves, sending prayer hands into the air and tears spilling from the eyes of loved ones and strangers alike.

But there were smiles too; and white, pink, blue, and purple bloomed in the crowd of black funereal clothes, woven among bright dresses, pressed shirts, ribbons and flowers.

“Lord, we ask right now a special prayer for Summer Grove School. Lord God, we pray for Lynnwood Public Charter School,” Pastor Al George said during his tribute, praying for the two schools the children had attended.

“We pray for all of those teachers, those principals; Lord, they need you right now. Those students need you right now. They’re going to school and see empty desks; Lord God, they need you right now.”

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Some of the funeral attendees were family, friends and teachers, and many were complete strangers – people who drove more than 12 hours just to stand witness to the unimaginable loss of children they had never met.

“I had to get here,” Kelvin Gadson told CNN. He had arrived a day earlier, having driven from South Carolina, and attended an open viewing of the caskets at a funeral home – the first time the mothers were able to see their children’s bodies.

But Gadson wasn’t just there to honor the children lost. He came for the children still here, the ones now carrying images no child should ever have to carry. With him were two costumes: Minnie and Mickey Mouse. The kids could pose with them as a distraction from what they’d just witnessed.

“They come out scared. But I’m really here because this violence has to stop. It’s killing our children, our precious babies,” Gadson, the founder of Giving a Child a Dream Foundation, told CNN. “My mission is about preventing gun violence.”

Little ones who came out of the casket viewing with their parents wore expressions of confusion and shock after witnessing eight bodies that didn’t look so different from their own.

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One of the children was Micheal Thomas.

“I’m kind of scared of funerals. I’m scared of the dead bodies, and they were pretty kids,” the 10-year-old said, sounding wiser than his years. “They were little. I wish I knew them, we would’ve been playing basketball, football, it would’ve been so fun.”

His friends at school don’t talk about the children as much as he does, he said. Then he points to his little brother, who hides behind his legs and clings tightly to him. “I care because imagine that was your kid. If it was my brother, I would be dying; I would be down bad.”

One day, he said, he will meet them in heaven and tell them, “Hey! How you doing? I’m doing good. You broke my heart, but I was talking about you.”

He hasn’t cried about seeing their bodies but he knows he will. The tears “don’t want to come,” but when they do, he promised he won’t push them back.

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Plastic trucks and ribbon-wrapped dolls

Days after the shooting stunned Shreveport, a whirlwind of police lights, camera crews and grieving relatives swarmed the neighborhood where the killings unfolded, the streets vibrating with sirens, the air shrouded in questions and disbelief.

But today, the home sits almost unbearably silent.

The main road leading to the Cedar Grove house where the children were killed is under construction. Jagged pieces of cement push through the dirt as orange and white caution cones warn drivers of danger. While less than half a mile away, innocent children received no warning at all before encountering the worst danger imaginable.

Eight balloons sway weakly in the wind above a makeshift memorial – eight crosses staked into the damp ground, covered in handwritten messages. Toys cover the lawn: stuffed animals, plastic trucks, dolls still wrapped in ribbons, left behind for children who will never come outside to claim them.

Besides the permanent stain the massacre has left on the neighborhood, it remains, in many ways, still beautiful — homes resting in the midst of lush green grass, children playing on porches, and neighbors blasting Michael Jackson as a family gathers around a table outside.

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A young girl sits slouched in a chair, chin in her hands, bored. It is a neighborhood that, in quieter moments, feels almost like childhood nostalgia made real — fragile, ordinary, and proof of how quickly innocence can be shattered.

In front of the memorial, a small gray cat sits in the rain before wandering to the front door of the gray and white home, curling near the entrance where blood had been spattered just weeks earlier. The gunman was identified as 31-year-old Shamar Elkins. Shreveport Police Cpl. Chris Bordelon told CNN affiliate KSLA the shootings were “domestic in nature.”

As the shooting unfolded, some of the children tried to escape out the back, a state representative said at an earlier news conference. Bullet holes could be seen in the back door of one of the homes.

Every now and then, a car slows to a crawl before pulling over beside the memorial, the people inside sitting silently behind fogged windows, perhaps reminiscing, perhaps praying, perhaps simply trying to make sense of a loss too enormous to truly understand.

Not far from the now empty home, stripped of the laughter and the innocent chaos of excited children that once filled every room and hallway with life, the three mothers, dressed in all white, sit side by side before the eight caskets.

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Keosha Pugh — sister of Shaneiqua Pugh, the gunman’s wife — walked into the funeral leaning on a cane, a painful reminder of the injuries she suffered after jumping from a roof with her daughter, Mar’Kianna, while fleeing the gunfire. The fall shattered her pelvis and hip. Shaneiqua Pugh escaped physically unharmed, but Snow was shot in the face during the attack.

All three mothers carried the visible weight of trauma throughout the service. Their legs trembled beneath them, their hands and heads shook with anxiety, and at times Snow, in tears, curled into the arms of friends and loved ones.

Prayers were recited over the bodies of their babies after horse-drawn carriages carried the children slowly into the cemetery as mourners followed behind, some arms carrying flowers and others carrying young children.

Roses were gently laid across the caskets before eight white doves were released into the sky, their wings unfurling into the clouds — a cruel irony beside the eight young lives below, cut short before their stories ever had the chance to unfurl at all.

Among the mourners was Dollie Sims, who had met the children when their father brought them to her community programs. She recalls being struck by how deeply loved they were. When she learned of their killing, she said she was stunned and retraumatized.

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“This was reliving the gun violence of my son, who was shot 15 times walking down the street. This is surreal, and as a parent, I think all of us out here are just devastated because what makes this situation so traumatic is that it was by their father, who struggled with mental illness,” Sims said, donning a white fur coat and dress as she waited for the family to arrive at the cemetery.

Her son, who survived, was 19 years old at the time of the shooting.

“This should open the eyes to Shreveport, Louisiana, and Louisiana period, about gun violence and its seriousness, and what we need to do to help this situation to make it safer … We need to advocate and support other families and show up and try to find a way to make it better to keep the next family safe.”

Sims believes the full impact of the tragedy has not fully hit the mothers who have not yet been given time to grieve, she said.

“Mother’s Day is just going to be the beginning of them realizing that those babies aren’t there anymore.”

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A few blocks away from the cemetery, Sharon Pouncy had up a folding table beside the road to sell Mother’s Day gift baskets. She lost her own child years ago, she said, after he became sick.

“I want these mamas to know that every mother is holding them in their hearts today,” Pouncy said from the driver’s seat of her truck. She’s wearing a Minnie Mouse shirt – unbeknownst to her, the character is a favorite of the children she had come to honor.

“We know your pain. Once you feel that loss, it never really goes away, you just …” She pauses, and a sad smile flickers across her face. “Well, you just find a way to live with it forever.”

At the same time three mothers lay their babies into the earth; another mother, years into her own journey of grief, finds herself thinking of her baby too.

A man pulls over and points to a basket he’s interested in buying. A card pokes out from a pile of teddy bears: “I love you, Mom.”

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