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... Few states stand to lose as much from the megabill that President Donald Trump signed into law as Louisiana.

With more poverty and disease than most of the country, Louisiana relies heavily on Medicaid benefits going to people who lack the means to cover a doctor's visit on their own.

That fragile lifeline is now in jeopardy.

The "Big Beautiful Bill" that Trump muscled through Congress chops Medicaid spending by nearly $1 trillion over the next decade.

Out of sheer self-interest, Louisiana might seem a state that would fight to preserve Medicaid. About 35% of Louisianans under the age of 65 were covered by Medicaid in 2023, the most recent year data was available. That figure is the second highest among the 50 states, according to KFF, a nonpartisan health policy organization.

The state voted heavily for Trump in the 2024 election and, polling shows, appreciates the job he's doing as president.

Louisiana loves Trump but needs Medicaid. How does a deep-red state reconcile the two?

Interviews with a dozen Louisianans, most of whom supported Trump, suggest that many in the state have absorbed the arguments that Trump and his congressional allies used to sell the bill.

A few warning signs for Trump emerged. Some of his voters aren't thrilled with what they describe as his bombast or are skeptical the measure will live up to its grandiose title. ...