In the rural South where Medicaid has been a lifeline, residents brace for cuts

"LAKE PROVIDENCE, La. East Carroll Parish sits in the northeastern corner of Louisiana, along the winding Mississippi River. Its seat, Lake Providence, was once a thriving agricultural hub of the region. Now, charred and dilapidated buildings dot the small city center. There are a few gas stations, a handful of restaurants and little to no industry. Mayor Bobby Amacker, 79, remembers a time when "you couldn't even walk down the street" in Lake Providence's main business district because "there were so many people.""

""It's gone down tremendously in the last 50 years," said Amacker, a Democrat. "The town, it looks like it's drying up." Now, East Carroll residents stand to lose even more with the pending cutbacks to Medicaid, which covers many low-income people in the region. Like many people in Louisiana, they received a lifeline when the state expanded Medicaid in 2016."

"State health data show the number of people on Medicaid in East Carroll Parish increased from about 53% in 2015 to about 64% in 2023, according to state health data. Many now worry those gains in coverage could disappear. The tax and spending bill President Donald Trump signed into law this summer includes nearly $1 trillion in cuts over the next decade to Medicaid, the joint state-federal health insurance program for poor families and individuals."

Lake Providence and East Carroll Parish have experienced economic decline, with charred buildings and limited industry in the city center. Medicaid expansion in 2016 increased coverage and lowered Louisiana's uninsured rate, raising East Carroll enrollment from about 53% in 2015 to about 64% in 2023. Federal tax and spending legislation signed this summer includes nearly $1 trillion in Medicaid cuts over the next decade and imposes work reporting and more frequent eligibility verification for expansion enrollees. Researchers estimate the law could cause hundreds of thousands of low-income Louisianans to lose coverage, and many residents fear coverage gains will disappear.

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