Medicaid cuts would hit rural Louisianans especially hard – here's how

Amite's Rural Health Clinic is a hub of health care and resources. This small clinic does such invaluable work that the Louisiana Rural Health Association named it the 2024 Outstanding Rural Health Organization of the Year award recipient. My family visits this clinic often, but my 18-year-old son, Connor, visits it the most.

Connor was born with multiple disabilities and requires round-the-clock care to meet his daily needs. In addition to his physical and cognitive disabilities, he is incredibly medically fragile. Our rural health clinic has come to his aid more times than I can count, and I trust them with his care outside of Manning Family Children's in New Orleans.

With the passing of Speaker Johnson's budget resolution requiring the Energy Committee to identify at least $880 billion in mandatory spending cuts over the next 10 years, I wonder how those cuts would affect clinics like mine in rural areas across our state.

As an avid disability and mental health advocate over the last 15 years, I am aware that it's unfeasible to hit a target so high without considerable cuts to the Medicaid program.

With the Energy Committee beginning to design the policy to achieve President Donald Trump's agenda, advocates like me are sounding the alarm – the specifics of the proposal matter. The president and speaker say they'll target fraud, waste and abuse to reach their $880 billion mark. But what exactly does that mean? And can those terms be misleading?

I've read the talking points from our nation's capital about rampant improper payments in the program. As executive director of the Louisiana Rural Mental Health Alliance, I discuss these payments daily and feel clarity must be provided here.

These payments generally mean insufficient documentation by good and ethical providers. Someone forgot to check a box or sign page 24. The six managed care plans address these improper payments in Louisiana quite well. If we did tally up all the improper payments and recoup those funds, it would not come anywhere near the savings policymakers in D.C. are talking about.

Over the last decade, I have worked with legislators in Baton Rouge to root out fraud in the Medicaid program through legislation and policy changes at the Louisiana Department of Health. I've performed extensive research on the topic and found that the Government Accountability Office outlines many recommendations to reduce fraud, waste and abuse – none of which include shifting Medicaid costs from the federal government to the states.

Louisiana ranks second in the number of Medicaid enrollees per population – 32.4 percent. With possibly fewer dollars coming from the federal government, Louisiana would bear a larger share of Medicaid costs. This concerns those who rely on Medicaid, but it should concern everyone.

Where will the savings come from outside fraud, waste and abuse? Tightening eligibility requirements? Limit the services covered? Decrease provider rates? These decisions will negatively impact Louisianans.

So, what would a significant funding decrease to Medicaid look like in Louisiana?

Rural providers will be forced to reduce or eliminate essential services or close their doors, limiting access to care for rural residents. Hospitals and other providers, especially mental health providers, in rural communities are already operating on tighter margins and disproportionately rely on Medicaid for their patient revenues. This could be the nail in their coffin.

With 72.5 percent of Louisiana's public school students categorized as economically disadvantaged, we can expect these students' access to primary care will be impacted.

For individuals like my son Connor, significant cuts to Medicaid are a matter of life and death. Medicaid allows my son to receive skilled nursing at home while my husband and I work full time. It also allows my son to receive support through case management, support professionals and durable medical equipment that keep him healthy at home and in his community. Medicaid is a lifeline to him and so many others.

Cutting federal spending on Medicaid does not eliminate health care needs, it'll simply shift the costs to state's justice system, uncompensated care, private insurers and employers and institutions.

If our leaders in D.C. want to make the Medicaid program run more efficiently, they'll take block grants, caps and work requirements off the table. In its place, they should invest in better claims processing and eligibility systems that flag the bad actors on the front end, so rightful beneficiaries aren't punished on the back end.

Katie Corkern is the executive director of the Louisiana Rural Mental Health Alliance.