In the rural South where Medicaid has been a lifeline, residents brace for cuts

toggle caption Shalina Chatlani/Stateline

LAKE PROVIDENCE, La. — East Carroll Parish sits in the northeastern corner of Louisiana, along the winding Mississippi River. Its seat, Lake Providence, was once a thriving agricultural hub of the region. Now, charred and dilapidated buildings dot the small city center. There are a few gas stations, a handful of restaurants — and little to no industry.

Mayor Bobby Amacker, 79, remembers a time when "you couldn't even walk down the street" in Lake Providence's main business district because "there were so many people."

"It's gone down tremendously in the last 50 years," said Amacker, a Democrat. "The town, it looks like it's drying up."

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Now, East Carroll residents stand to lose even more with the pending cutbacks to Medicaid, which covers many low-income people in the region.

Like many people in Louisiana, they received a lifeline when the state expanded Medicaid in 2016. Expansion drove Louisiana's uninsured rate to the lowest in the Deep South, at 8% in 2023 for working-age adults, according to state data, despite it having the highest poverty rate in the U.S. that year.

State health data show the number of people on Medicaid in East Carroll Parish increased from about 53% in 2015 to about 64% in 2023, according to state health data.

Many now worry those gains in coverage co