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A view of St. Patrick Hospital in Lake Charles, Louisiana. Photo by Andy Sullivan/Reuters
It’s Tuesday, the traditional day for elections and for our pause-and-consider newsletter on politics and policy. We think of it as a mini-magazine in your inbox.

IN LOUISIANA, 3 QUESTIONS ON MEDICAID CHANGES
By Lisa Desjardins, @LisaDNews ([link removed])
Correspondent

The conversation about Medicaid, for the past six months, has been centered in Washington.

But the effects of the Trump-titled “One Big Beautiful Bill Act” are far more significant outside the U.S. Capitol.

This is why we are in Louisiana this week.

Fifteen minutes after I landed, my Uber driver told me he tried to get onto Medicaid in the last year or so but he makes too much money. (He said he makes $2,000 a month.)
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Dana Jett, an Uber driver in Louisiana, spoke with PBS News about his attempt to enroll in Medicaid last year. Photo by Lisa Desjardins/PBS News

“Medicaid is a major issue here,” he told me.

There are three questions we are hoping to answer while here.

1. How will the changes and cuts in Medicaid spending affect places where it is most used?

Nearly one in three people in Louisiana get their health care from Medicaid, known as “Healthy Louisiana.” ([link removed]) Per the nonpartisan KFF organization, the figure is 31.9 percent.

That compares with 21.2 percent nationally.

Starting in 2026, the OBBBA will put in place several changes affecting nearly everyone on Medicaid:
* Recipients will need to verify their income every six months.
* Those between 19 and 64 who are “able-bodied” (or those without disabilities) and do not have a young child will have to work or volunteer 80 hours a month.
* States will have to cut a key source of revenue — Medicaid provider taxes. ([link removed])

Overall, the Congressional Budget Office has estimated ([link removed]) that the bill will mean 10 million fewer people with health insurance in 2034.

Few places may feel this more than Louisiana.

It is a place with high Medicaid rates and sobering health statistics. The nonprofit United Health Foundation has rated Louisiana as having the least healthy state in the nation. ([link removed])

At the same time, the OBBBA increases the burdens and costs to states. And places like Louisiana have to juggle health outcomes and potential state budget crunches.

2. How will hospitals and caregivers on the ground adjust?

The changes will most directly affect rural hospitals and clinics ([link removed]) , which have an outsized reliance on Medicaid funding.

As part of the final bill, Congress passed some $50 billion to make up for their potential losses.

One of our key questions: How these places are already starting to adjust to anticipated funding cuts more than a year down the road.

As I type this, we are driving to the small city of Franklin, west of New Orleans. We’ll be speaking with doctors and also patients, including a single mom of three. She is likely to keep her coverage but is concerned about what the cuts mean for the overall resources to the clinics and hospitals she uses.

3. What will this mean for political leaders in places where people fall off or otherwise lose coverage, while total costs for the state likely go down?
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A view of the Louisiana state Capitol in Baton Rouge. Photo by Chris Graythen/Getty Images
We spent Monday at the towering Louisiana state Capitol, interviewing Republican state Sen. Heather Cloud.

She sponsored and successfully passed a state bill ([link removed]) to initiate smaller reforms in Medicaid there. Primarily, the law aims to ensure that only people living in Louisiana get Medicaid benefits paid by the state.

Her district is one that has heavy reliance on Medicaid, a place where the poverty rate is an estimated 20 percent.

But critics warn that the new eligibility checks and changes in auto renewals could lead to vulnerable people falling out of Medicaid. ([link removed])

In our interview, Cloud was direct about this, saying she is worried about the stability of the program and wants to protect those who are most in need of it. Growing up, she and her family depended on state safety net programs for health care.

“What if you are wrong,” I asked her, and the vulnerable do end up losing health care? Her answer was that this is why she and other lawmakers need to carefully watch what happens with these changes.

Voters will be watching these changes as well.

Signing off from the road, with a story to air next week,
Lisa
More on politics from our coverage:
* Watch: What to expect from the new U.S.-EU trade framework ([link removed]) announced by Trump.
* One Big Question: Is the president's approach to the world economy working? NPR’s Tamara Keith and Jasmine Wright of NOTUS discuss. ([link removed])
* A Closer Look: Inside “Project Esther” and Trump’s approach to combat antisemitism on campus. ([link removed])
* Perspectives: Aid worker with Save the Children on the “catastrophic” rise ([link removed]) in malnourished children and families in Gaza.

THE ‘DEEP CONCERN’ OVER RFK JR.’S REPORTED PLANS TO OUST ANOTHER MEDICAL PANEL

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Watch the segment in the player above.

By Jackson Hudgins
National Affairs Producer

Health and Human Services Secretary Robert F. Kennedy may be making major changes to another influential medical panel of experts.

Weeks after firing all members of a key vaccine advisory panel ([link removed]) , Kennedy plans to remove all 16 members of the United States Preventive Services Task Force, The Wall Street Journal reported late last week. ([link removed])

What is the USPSTF? The panel plays a key role in determining what treatments insurers must cover and makes recommendations about care that are followed by doctors across the country. That includes cancer and diabetes screenings, and other preventative health measures such as HIV and cholesterol drugs.

Why is Kennedy planning to oust the panel? People familiar with the situation told the Journal that he views the panel members as too “woke.”

There was a swift rebuke. The American Medical Association released a letter Sunday, expressing “deep concern” ([link removed]) over Kennedy’s possible plan to remove USPSTF members.

PBS News’ Stephanie Sy spoke with Dr. Bobby Mukkamala, surgeon and AMA president, on how this kind of move could have big implications for the health care system ([link removed]) , especially for the some 100 million privately insured people who get preventative services each year — at no cost — under requirements of the Affordable Care Act.

Mukkamala said the current make-up of the panel was doing a good job, providing useful recommendations based on science.

“Not knowing what's going to come next is putting our patients' health at risk and the health of this country at risk,” he said.

THIS WEEK’S TRIVIA QUESTION

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Watch the segment in the player above.

By Joshua Barajas
Senior Editor, Digital

Another recent letter of rebuke came from more than 360 current and former NASA employees who pushed back against the Trump administration’s proposal to slash the agency ([link removed]) by about 25 percent.

Addressed to Transportation Secretary Sean Duffy, the interim NASA administrator, the “Voyager Declaration” letter ([link removed]) says these cuts would “threaten to waste public resources, compromise human safety, weaken national security, and undermine the core NASA mission.”

If enacted, the cuts would take effect in the next fiscal year.

Our question: Which U.S. president signed the law that created NASA?

Send your answers to [email protected] (mailto:[email protected]) or tweet using #PoliticsTrivia. The first correct answers will earn a shout-out next week.

Last week, we asked: Which American patriotic song evolved from a poem penned by Katharine Lee Bates after she made a trip to Pikes Peak in Colorado?

The answer: “America the Beautiful.” ([link removed]) In her own words, Bates described how the 1893 trip inspired her poem, “purple mountain majesties” and all: “I was looking out over the sea-like expanse of fertile country spreading away so far under those ample skies, that theopening lines of the hymn ([link removed]) floated into my mind."

Congratulations to our winners: Ed Witt and Sarah Bornstein!

Thank you all for reading and watching. We’ll drop into your inbox next week.
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