\u201cI\u2019ve never met a congressman yet that wanted a rural hospital in their district to close, and certainly Mike is no exception to that rule,\u201d Eppler said.<\/p>\n
Last year nearly 290,000 people in Johnson\u2019s district were enrolled in Medicaid, about 38% of the total population, according to data compiled by KFF, the health information nonprofit that includes KFF Health News.<\/p>\n
About 118,000 of them are in the program thanks to the Affordable Care Act, which allowed states including Louisiana to expand Medicaid to cover low-income adults, many of whom were working in low-paying jobs that don\u2019t provide health insurance.<\/p>\n
Louisiana ranks second in Medicaid enrollment, at nearly 32% \u2014 a reflection of the state\u2019s high poverty rate. As Republicans weigh cuts, their actions could have dramatic consequences for their constituents here. Of the eight GOP-held House districts with the most Medicaid enrollees due to the expansion, four are in Louisiana. Johnson\u2019s largely rural district ranks sixth in expansion enrollees.<\/p>\n
Among them is Chloe Stovall, 23, who works in the produce aisle at the SuperValu grocery store in Vivian, Louisiana. She said her take-home wage working full time is $200 a week. She doesn\u2019t own a car and walks a mile to work.<\/p>\n
The store provides health coverage, but she said she won\u2019t qualify until she\u2019s worked there for a full year \u2014 and even then, it will cost more than Medicaid, which is free.<\/p>\n
\u201cI\u2019m just barely surviving,\u201d she said.<\/p>\n
In February, Johnson pushed a budget resolution through the House that calls for cutting at least $880 billion over a decade from a pool of funding that includes Medicaid, to help fund an extension of Trump\u2019s tax cuts and his border priorities. Republicans in Congress are now considering where to make cuts, and Medicaid is likely to take a big hit.<\/p>\n
Defending the plan, Johnson said that Medicaid is \u201cnot for 29-year-old males sitting on their couches playing video games.\u201d<\/p>\n
Stovall said almost everyone she knows on Medicaid works at least one job. \u201cI don\u2019t even own a TV,\u201d she said.<\/p>\n
Contacted for comment, Johnson\u2019s office pointed to his remarks at a conference in Washington last month. \u201cWe\u2019re going to be very careful not to cut a benefit for anyone who is eligible to receive it and relies upon it,\u201d Johnson said.<\/p>\n
KFF Health News spoke with two dozen Medicaid enrollees in Johnson\u2019s district. Most said they were unaware their congressman is leading the Republican charge to upend the program. Those informed of the Republican plan said it scares them.<\/p>\n
Some GOP members of Congress want to eliminate the ACA\u2019s Medicaid expansion funding, which led to 20 million working-age adults gaining coverage and helped slash the nation\u2019s uninsured rate to its lowest level in history. Forty states and the District of Columbia have agreed to the change, which promised extra federal funding in exchange for expanding eligibility.<\/p>\n
In this heavily Republican district, where Johnson won with 86% of the vote in November, 22% of residents live in poverty.<\/p>\n
Like Trump, Johnson says he wants cuts to Medicaid but hasn\u2019t elaborated other than saying the program should not cover \u201cable-bodied\u201d adults without imposing a work requirement.<\/p>\n
\u201cEverybody is committed\u201d to preserving Medicaid benefits \u201cfor those who desperately need it and deserve it and qualify for it,\u201d Johnson said at a news conference in February. \u201cWhat we\u2019re talking about is rooting out the fraud, waste, and abuse.\u201d<\/p>\n
Medicaid recipients in Johnson\u2019s district, told about GOP plans to cut the program, said their lives are hard enough in a state where the minimum wage is $7.25 an hour. Without Medicaid, they said, they couldn\u2019t afford health coverage.<\/p>\n
In Vivian, near the borders with Arkansas and Texas, close to half of the 2,900 residents live in poverty. The main-street shops are mostly shuttered, except for a thrift store and a mom-and-pop restaurant that specializes in fried pork chops.<\/p>\n
\u201cMost everybody you know is on Medicaid here,\u201d said Doris Luccous, 24.<\/p>\n
![](\"http:\/\/shapegreatness.org\/wp-content\/uploads\/2025\/04\/Louisiana-resized-scaled.jpg\")
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Luccous said she makes $250 a week after taxes as a housekeeper at a nursing home while raising her 2-year-old daughter in her childhood home. While shopping with her father \u2014 who doesn\u2019t work, because of a disability \u2014 she said she counts on Medicaid for her bipolar medicines and to pay for therapy appointments.<\/p>\n
\u201cI don\u2019t know where I would be without it,\u201d she said.<\/p>\n
Neither Luccous nor Stovall said they voted in the last election, and neither knew that Johnson is their representative in Congress.<\/p>\n
Vivian has few large employers, and most employers pay the minimum wage, which hasn\u2019t changed since 2009. \u201cWe are just stuck,\u201d Stovall said.<\/p>\n
Still, she said, \u201cit\u2019s a community where everybody knows everybody, and people are always willing to lend a hand because so many are in difficult financial circumstances.\u201d<\/p>\n
Willie White is CEO of David Raines Community Health Centers, which operates six outpatient clinics in northwestern Louisiana that serve primarily Medicaid enrollees. He said that Louisiana already ranks among the worst states for people\u2019s health and that Medicaid cuts would only worsen the situation.<\/p>\n
\u201cYou cannot expect health outcomes to improve if people can\u2019t afford to access care,\u201d White said.<\/p>\n
![](\"http:\/\/shapegreatness.org\/wp-content\/uploads\/2025\/04\/White_David_Raines-scaled.jpg\")
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While the clinics provide primary and dental care on a sliding fee scale for uninsured patients, signing them up for Medicaid gives them better access to specialists and brings the health centers revenue to cover the cost of delivering care.<\/p>\n
Many of the centers\u2019 patients gained coverage through Medicaid expansion. Afterward, rates of screenings for colon and cervical cancer went from 10% to 50%, White said.\u00a0<\/p>\n
But if Congress cuts Medicaid, the health centers would be forced to cut services, he said.<\/p>\n
\u201cMike Johnson has been here and knows us, and he and his office have been responsive about our issues,\u201d White said. \u201cThe message in prior years was, \u2018We need additional funding,\u2019 but now it is asking for no cuts.\u201d<\/p>\n
Community health centers, which in 2023 provided care nationally to more than 32 million mostly low-income people, have seen funding increases from Republicans and Democrats for decades.<\/p>\n
\u201cEveryone is supportive, but the question remains what that support will look like under the current administration,\u201d White said. \u201cIf there are to be reductions, they need to be done with a scalpel.\u201d<\/p>\n
Expecting cuts, the health centers have already restricted travel and put a hold on filling vacant positions, White said.<\/p>\n
Sitting in a David Raines clinic in Bossier City, Benjamin Andrade, 57, said having Medicaid has been a lifesaver since he needed heart surgery in 2020. Andrade is a chef and said he supports his wife and two children on $14 an hour.<\/p>\n
He had not heard about any potential cuts to the program. Without Medicaid, he said, \u201cit would be very hard for me to pay for all the medicines I take.\u201d<\/p>\n
Dominique Youngblood, 31, who was at the clinic for a dental checkup, said she\u2019s had Medicaid most of her life. \u201cMedicaid helps me so I don\u2019t have to pay out-of-pocket going to the doctors,\u201d she said.<\/p>\n
![](\"http:\/\/shapegreatness.org\/wp-content\/uploads\/2025\/04\/Youngblood-scaled.jpg\")
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Youngblood, who has two children, makes $12 an hour at a day care center. Asked about GOP efforts to scale back the program, she said, \u201cIt\u2019s not fair, because it helps a lot of people who cannot afford medications and emergency room trips, and those are costs you can\u2019t control.\u201d<\/p>\n
Back in Mansfield, Eppler\u2019s hospital is more than just a health facility \u2014 it\u2019s where many people in town come for lunch. The cafeteria was packed on a recent Friday as workers served boiled shrimp, fried okra, and baked fish.<\/p>\n
Eppler said he\u2019s aware Republicans in Congress are targeting a system of taxes that some states, including Louisiana, levy on hospitals and other health providers to draw down more federal Medicaid funding. That money helps finance what are known as supplemental payments to providers. Some conservatives belittle the extra funding as \u201cmoney laundering.\u201d<\/a><\/p>\n But that money accounts for about 15% of the DeSoto health system\u2019s budget, said Eppler, a retired Air Force lieutenant colonel who has been CEO for a dozen years. \u201cWe are using that money to invest in the next 50 years of Desoto Parish, to build a hospital that they can have that will be sustainable,\u201d he said.<\/p>\n The supplemental payments, for example, help pay to provide mental health services at three outpatient clinics. \u201cIf that $4 million went away, we would have to limit services \u2014 it\u2019s just that simple,\u201d he said.<\/p>\n KFF Health News<\/a> is a national newsroom that produces in-depth journalism about health issues and is one of the core operating programs at KFF\u2014an independent source of health policy research, polling, and journalism. Learn more about KFF<\/a>.<\/p>\n![](\"http:\/\/shapegreatness.org\/wp-content\/uploads\/2025\/04\/Eppler_Desoto_01-scaled.jpg\")
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