Trump's new tax and spending bill ties Medicaid to work rules starting in 2027—some could lose coverage even earlier, depending on their state.

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.

President Donald Trump on Friday signed the tax and spending cut bill Republicans muscled through Congress this week, turning it into law by his own self-imposed Fourth of July deadline. At nearly 900 pages,