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.

Trump's new tax and spending bill ties Medicaid to work rules starting in 2027—some could lose coverage even earlier, depending on their state.