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.

It also takes aim at Medicaid, the federal and state health program that covered 78.6 million low-income children and adults as of March 2025, according to the Centers for Medicare & Medicaid Services.

The legislation increases the federal excise tax reimbursement on rum imported from Puerto Rico, imposes new limits on full access to Pell grants and restricts the island’s access to the opportunity z