Conservatives Can Protect Medicaid—and Ensure It Works for Those Who Truly Need It

In northwest Louisiana, Medicaid plays a vital role in supporting working families, seniors, and vulnerable citizens. But as Speaker Mike Johnson leads efforts in Congress to rein in out-of-control federal spending, Medicaid—like all major entitlement programs—must be carefully examined to ensure it remains sustainable and effective for future generations.

At the center of this conversation is DeSoto Regional Health System in Mansfield, a hospital that’s served the region since 1952 and is now undergoing a $36 million renovation. That investment was made with the understanding that Medicaid would continue to support rural health care providers. CEO Todd Eppler acknowledges that changes to funding could impact operations—but also recognizes the need for long-term stability. “We have to keep these facilities open—but we also know the dollars need to be used wisely,” he said.

Speaker Johnson has been clear: fraud, waste, and abuse in the system must be addressed, and resources should be focused on those who are truly eligible. It’s a message that resonates across his largely rural, hard-working district. With nearly 290,000 residents enrolled in Medicaid—many as a result of the ACA’s expansion—it’s clear the program reaches far and wide. But the growth in costs must be balanced with commonsense reforms that promote personal responsibility and reduce dependency.

Critics of reform often paint a bleak picture, but the reality is more nuanced. Take Chloe Stovall, 23, who works full time in a grocery store in Vivian and walks a mile each way to get to work. She’s doing what conservatives believe in—earning a living and striving for self-reliance. For individuals like Chloe, reforms should ensure that the safety net remains intact without becoming a trap. Expanding access to affordable private insurance through market-based solutions could provide a better path forward than permanent dependence on government programs.

Doris Luccous, a young mother working as a housekeeper, uses Medicaid to access mental health services. Her story illustrates why conservatives support prioritizing the truly needy. No one is suggesting that people like Doris should be left behind—but reforming Medicaid doesn’t mean eliminating it. It means protecting it from insolvency and ensuring it delivers care effectively.

Local health centers like David Raines, which serve thousands across the district, have also benefited from Medicaid. CEO Willie White has seen firsthand how coverage has improved health outcomes. At the same time, he acknowledges the need for responsible management. “We’re not asking for more,” he said. “We just want stability.”

Speaker Johnson has proposed a budget that includes significant federal savings—at least $880 billion over the next decade—with reforms to entitlement programs like Medicaid. These changes are part of a broader effort to extend tax relief, strengthen national security, and reduce the deficit. Critics call them “cuts,” but conservatives call them overdue responsibility.

Supplemental Medicaid funding—such as Louisiana’s provider tax model—deserves close scrutiny to ensure federal dollars are being used transparently. Some call it “money laundering,” others see it as a necessary funding tool. Either way, it’s time for an honest, data-driven evaluation of what’s working and what isn’t.

The bottom line: Medicaid must remain a safety net, not a hammock. For those who are working hard, raising families, and managing health challenges, the system should be there—but it must be efficient, targeted, and free of abuse.

Speaker Johnson understands the stakes—and he’s uniquely positioned to lead on conservative Medicaid reform. His constituents need a system that’s fiscally responsible, patient-focused, and built to last.

We can protect Medicaid and protect taxpayers. It’s not an either/or—it’s a must.