Louisiana’s Republican delegation just made a devastating choice, voting to preserve massive tax cuts for the wealthy, while stripping health care from nearly 200,000 of their own constituents.
With their support for Donald Trump’s so-called “One Big Beautiful Bill,” passed in the Senate on July 1 and expected to clear the House this week, Louisiana Republicans have drawn a brutal line in the sand. On one side, the bill provides corporate tax breaks, hedge fund loopholes, and an estimated $300,000 annual windfall for the top 0.1% of earners. On the other side, the bill guts working-class Louisianans who rely on Medicaid for lifesaving care, and who now face being kicked off the rolls because they are too old, too sick, or too poor to meet new work requirements.
The contrast is stark and immoral.
Billions for the Rich
The One Big Beautiful Bill (OBBBA) is being marketed as a tax relief package for all Americans; but, the truth, buried in the fine print, is that this is a generational giveaway to the ultra-wealthy. According to the Tax Policy Center, more than 45% of the bill’s total tax cuts will go to the top 5% of earners. For the top 0.1%, that’s a staggering $300,000 per year in tax breaks.
In total, the bill locks in nearly $4.5 trillion in lost federal revenue over ten years. The majority of that money will be diverted to those who already have more than enough—corporate executives, investors, and yes, even health insurance CEOs. Meanwhile, ordinary families will get crumbs. Some will see minor deductions for tips or overtime. Others will see nothing at all.
And Cuts for the Rest
To pay for these tax cuts, Republicans didn’t target waste or bloated defense spending. Instead, they went after Medicaid and SNAP—programs that serve the poor, elderly, and disabled.
Under this bill, Medicaid will be slashed by over $1.2 trillion, according to CBO estimates. Work requirements will be imposed on adults ages 19–64, along with more frequent eligibility checks and new administrative hurdles. The Kaiser Family Foundation estimates between 10.9 and 12 million people nationwide could lose their coverage.
In Louisiana, the consequences are catastrophic.
Louisiana: The Epicenter of the Fallout
More than 1.9 million people in Louisiana rely on Medicaid. According to WWLTV, up to 190,000 residents could lose coverage under this bill. That includes pregnant women, cancer patients, and families with children who don’t have access to affordable private insurance.
The Louisiana Hospital Association warns the bill would strip over $4 billion annually from our state’s healthcare system. Entire hospitals—especially in rural parishes—are at risk of closing. Over 60,000 jobs in the healthcare sector could be lost, based on American Hospital Association job loss projections. That means fewer nurses, longer ER wait times, and more people dying because they can’t get care in time.
The response from our congressional delegation was silence and even deflection.
Johnson’s Shrug
When Speaker Mike Johnson was pressed by CBS’s Face the Nation about the potential loss of coverage for 190,000 Louisianans, he didn’t dispute the number. He simply called it “anti-fraud enforcement.” As if people with epilepsy, heart failure, or psychiatric disorders are gaming the system by trying to survive.
Johnson’s comments came just days after a letter signed by dozens of Louisiana hospital CEOs warned him directly that the legislation would “devastate our ability to provide care.” He ignored them. So did Senator Bill Cassidy, a physician who should know better. He voted for the bill in the Senate. So did Julia Letlow and Clay Higgins in the House.
They all knew the stakes, but they voted yes anyway.
Austerity for the Poor, Recession for Everyone
Stripping healthcare from hundreds of thousands of low-income Louisianans won’t just harm individuals—it will hurt the broader economy. When people lose coverage, they’re forced to pay out-of-pocket or delay care. That means less disposable income, more personal debt, and reduced consumer spending in their communities.
Medicaid is not just a social safety net. It’s also an economic engine. A study by the National Bureau of Economic Research found that Medicaid expansion increases household financial stability and local economic activity. Cutting it does the reverse.
Hospitals will also be forced to cut staff. According to the American Hospital Association, every $1 billion in Medicaid cuts results in 16,800 jobs lost. With $4 billion in projected cuts in Louisiana, that means more than 60,000 layoffs—many in small towns where hospitals are the largest employers.
And those job losses don’t stay isolated. They spread and have a ripple effect. When a nurse loses her job, she stops going out to eat. When a billing clerk is laid off, she can’t pay her car note. Demand for goods and services drops, small businesses suffer, and growth slows across the board.
Meanwhile, the wealthy—flush with their new tax windfalls—don’t spend in ways that stimulate the local economy. According to CBO and Fed studies, tax cuts for the rich produce little economic return, because high-income earners tend to save or invest in assets rather than circulating money through their communities.
So not only does this bill shrink Medicaid; it shrinks GDP, and worsens poverty. And because the tax cuts add over $2 trillion to the federal deficit, it could also drive higher interest rates and inflation, making everything more expensive for the very people now losing coverage.
It’s a vicious cycle, which includes austerity for the poor, windfalls for the rich, and stagnation for the rest of us.
The People Don’t Support This
Nationally, Americans are not fooled. A Washington Post–Ipsos poll found only 23% support the bill, while 42% oppose and 34% remain unsure. A Kaiser Family Foundation poll found that 64% of Americans hold an unfavorable view of the bill once they learn about the Medicaid cuts. Even among Republican voters, support is shaky.
In Louisiana, where poverty, poor health outcomes, and rural hospital closures are already at crisis levels, the disconnect between our representatives and their constituents could not be clearer.
Whose Side Are They On?
Republicans have once again shown they could care less about fiscal responsibility. Louisiana Republicans had a choice to either protect the health and dignity of their people, or deliver a political victory to Donald Trump and his billionaire backers.
They chose the latter.
They chose to sacrifice hospitals to preserve hedge fund tax loopholes. They chose to kick families off Medicaid to gift CEOs another yacht. They chose power over people.
And when the fallout comes—when the ERs overflow, patients die waiting, and when hospitals shut down—they will claim they were only trying to root out fraud. But we’ll remember who took away care from the poor to protect profits for the rich.
