Louisiana’s hospitals stand to lose hundreds of millions of federal dollars that they use to support care for low-income patients under the latest version of the budget reconciliation bill proposed by the Senate. State hospital leaders made their case this week to Louisiana Sen. Bill Cassidy, who is a pivotal vote on the deficit-busting tax-and-spending bill that could come for a vote as early as next week. The Times-Picayune | Baton Rouge Advocate’s Mark Ballard reports: 

(T)he language (in the Senate version) now has worried hospitals in rural areas of the state, whose patients are mostly on Medicaid, said Jeff Reynolds, executive director for the Louisiana Rural Hospital Coalition. “Right now, the way the bill reads,” Reynolds said, “all my member hospitals would have to see what programs they could reduce and what layoffs they’d have to in order to stabilize” their finances.

The Senate’s Medicaid cuts go much farther than those approved by the House by imposing stricter work requirements on recipients, cutting down on the ability of states to use “provider taxes” to finance their share of costs, and reducing lump payments that hospitals use to offset their costs of treating low-income patients. The Medicaid cuts are being sought to partially offset the cost of tax breaks and other benefits for wealthy people and large corporations. 

“States have gotten incredibly greedy about pulling down money from the federal taxpayer as governors and legislatures have decided to spend their own dollars on things besides Medicaid,” Cassidy said.

Meanwhile, The New York Times reports that congressional budget analysts now project that the House-backed version of the bill would add $3.4 trillion to the national debt – higher than an earlier projection of $2.4 billion. 

The budget office said that lower taxes would spur some American families and businesses to spend and invest more. But it also determined that the uptick in economic activity would not be sufficient to cover the costs of the legislation. Even after factoring in spending cuts, the proposal would still add nearly $2.8 trillion to federal deficits over the next 9 years, according to the official tally from C.B.O. The figure grows to about $3.4 trillion if the full costs of federal borrowing are included.

Housing cuts would cripple states

President Donald Trump’s proposed federal budget includes a 44% cut to the U.S. Department of Housing and Urban Development and calls for major changes to programs that help reduce the cost of housing for people with low incomes. Stateline’s Robbie Sequeira reports that the changes, which still have to go through Congress, would put new financial pressures on state governments and vulnerable families. 

Experts say any resulting aid cuts would disproportionately affect families with children, older adults and individuals with disabilities, many of whom rely on rental subsidies and support to remain stably housed in high-rent markets. “It would completely change how households might be able to receive rental assistance of any kind,” said Sonya Acosta, a senior policy analyst with the center. “It combines five of these programs that millions of people rely on, cuts the funding almost in half, and then leaves it completely to states to decide how to use that funding.”

Homelessness “crackdown” fizzles

Two attempts by state legislators to create criminal and legal penalties for unhoused people who camp outdoors without permission fizzled during the just-concluded legislative session. The Times-Picayune | Baton Rouge Advocate’s Sophie Kasakove reports that one bill would have made it a crime to camp without authorization, while another directed local governments to enforce a ban on unauthorized encampments. 

Both bills provoked loud backlash from critics who argued that punishing homelessness was inhumane and would not be effective without providing additional housing or mental health or drug treatment resources. The bills’ failure comes as a blow to one of Gov. Jeff Landry’s priorities during the legislative session, with the governor promising in January to “enact legislative reforms that should produce the framework necessary to properly move people from homelessness to housing.”

Mend, don’t end, FEMA

Louisiana and other disaster-prone states could be left to fend for themselves after a hurricane strikes if President Donald Trump gets his way. The president wants to eliminate the Federal Emergency Management Agency, arguing that states should be able to handle emergencies on their own. FEMA plays a critical role after disasters by distributing emergency aid to people who’ve been displaced. A Times-Picayune | Baton Rouge Advocate editorial calls for cooler heads to prevail.  

Louisianans know FEMA’s activities often get tangled in red tape, and we support efforts to unravel it. But we also know that its good work saves lives, homes and livelihoods. This should not be a partisan issue, and we’re glad that the state’s two Republican senators have spoken out about the agency’s importance. … We urge them to stick to their guns, and we also encourage House Speaker Mike Johnson and Majority Leader Steve Scalise to share Louisiana’s experiences with their peers in Congress — although, frankly, these days more and more of them are seeing the need with their own eyes.

Number of the Day

41 – Louisiana’s ranking on the 2025 Scorecard on Health System Performance, released Wednesday by the Commonwealth Fund. The scorecard includes 50 measures of healthcare access and affordability, prevention and treatment, avoidable hospital use and costs, health outcomes, healthy behaviors and equity. (Source: Commonwealth Fund)