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Louisiana has 41 community health centers across 552 sites serving 504,506 patients — the #18 FQHC state by patients outside California and Texas. As an expansion state, Medicaid anchors the safety net, and H.R. 1 work requirements plus the December 2026 funding cliff are the key risks.
Louisiana is a Medicaid expansion state where Healthy Louisiana covers roughly 700,000 low-income adults out of about 1.4 million total enrollees, leaving its 41 FQHC organizations (LPCA-represented) — which serve 503,329 patients — heavily exposed to H.R. 1's expansion-population work requirements taking effect January 1, 2027. LDH projects about 21,000 Louisianans will lose coverage, though the Urban Institute estimates up to 132,000, and centers also face the December 2026 federal Community Health Center Fund cliff. The brighter counterweight is a $208 million Year 1 Rural Health Transformation award (up to ~$1B over five years) that LDH is steering through a new Office of Rural Health Transformation to shore up rural hospitals, RHCs, and FQHCs across the Delta and other rural parishes.
Patient-weighted across the 40 centers with UDS 2024 data.
Louisiana is a reduced-practice (restricted) NP state: APRNs may diagnose, manage patients, and prescribe only within a written collaborative practice agreement with one or more licensed physicians, on a form provided by the Louisiana State Board of Nursing, with the collaborating physician available by telecommunication whenever the APRN exercises prescriptive authority.
Medicaid community-engagement (work) requirements under CMS-2454-IFC (80 hrs/month, full implementation Jan 1, 2027) plus expiry of the enhanced ACA premium tax credits (end of 2025) threaten Louisiana's expansion population and FQHC Medicaid revenue.
5 primary-sourced findings on Louisiana FQHC policy and financing.
The 2026 Consolidated Appropriations Act (enacted Feb 3, 2026) set the Community Health Center Fund at $4.6B for FY2026 but only extended its authorization through December 2026, not the multi-year reauthorization NACHC and advocates sought. For Louisiana's LPCA-member FQHCs — serving 503,329 patients and heavily federally dependent — the short-term extension means stalled hiring and construction unless Congress acts before the December 2026 cliff.
NACHC (National Association of Community Health Centers)LDH expects about 21,000 Healthy Louisiana enrollees to lose coverage when H.R. 1's 80-hours/month community-engagement requirement takes effect January 1, 2027, while the Urban Institute projects up to 132,000 adults at risk. Affected members aged 19–64 (non-exempt) renewing in January 2027 will be notified in May 2026 and receive renewal packets in November 2026 — a direct enrollment and PPS-revenue exposure for Louisiana's FQHCs serving 503,329 patients.
NOLA.com / The Times-PicayuneOn April 7, 2026, Governor Jeff Landry signed an executive order establishing the Office of Rural Health Transformation and Sustainability within LDH to run Louisiana's Rural Health Transformation Program, backed by a $208,374,448 Year 1 federal award (among the nation's highest) and an estimated ~$1B+ over five years. The program targets rural hospitals, Rural Health Clinics, FQHCs and community organizations for workforce, telehealth, EHR and infrastructure upgrades — reaching ~1.1M rural residents, 37% on Medicaid.
Louisiana Department of HealthLouisiana Department of Health's official work-requirements page confirms the Jan 1, 2027 start, the 80-hours/month or $580/month threshold, and the exemption list (pregnant women, parents of young children, foster youth under 26, the disabled, and those already meeting SNAP/TANF rules). It warns that failure to respond to Medicaid requests 'could result in health coverage closure' — making patient-navigation and redetermination support an urgent FQHC operational task in 2026.
Louisiana Department of HealthIn the 2025 Regular Session, the Louisiana House trimmed LDH funding by $26.3 million within Governor Landry's $49.4 billion FY2026 budget, even as the budget funded a $258.4 million Medicaid provider rate increase (Act 306 of 2024 / HB1 of 2025) and added $2.9 million for 750 more Community Choice Waivers. The state is also pursuing Medicaid savings via LDH–OMV data-sharing to drop recipients who no longer live in Louisiana — signaling tighter eligibility scrutiny that compounds FQHC redetermination risk.
Pelican Institute / Louisiana House Fiscal DivisionBy patients (HRSA UDS 2024). Tap for the full profile.
| Organization | Patients | Sites | Uninsured | Revenue (990) | District |
|---|---|---|---|---|---|
| Access Health Louisiana Kenner | 54,764 | 69 | 21.08% | $53M | LA-01 |
| Marillac Community Health Centers New Orleans | 45,772 | 39 | 15.73% | $51M | LA-01 |
| Winn Community Health Center Inc. Winnfield | 36,842 | 64 | 6.56% | $37M | LA-04 |
| Iberia Comprehensive Community Health Center, Inc. New Iberia | 28,114 | 13 | 12.17% | $34M | LA-03 |
| St. Thomas Community Health Center, Inc. New Orleans | 22,434 | 12 | 27.92% | $24M | LA-02 |
| Primary Care Providers for a Healthy Feliciana, Inc. Clinton | 22,043 | 70 | 13.26% | — | LA-05 |
| Start Corp Houma | 21,114 | 6 | 8.24% | — | LA-03 |
| Swla Center for Health Services Lake Charles | 21,049 | 6 | 22.94% | $23M | LA-03 |
| Capitol City Family Health Center Incorporated Baton Rouge | 18,202 | 23 | 13.77% | $36M | LA-06 |
| Primary Health Services Center Monroe | 18,020 | 12 | 13.4% | $15M | LA-05 |
3 hospital/university/county-operated: 3 hospital.
| District | Representative | Sites |
|---|---|---|
| LA-06 | Cleo Fields | 149 |
| LA-05 | Julia Letlow | 139 |
| LA-02 | Troy A. Carter | 127 |
| LA-04 | Mike Johnson | 60 |
| LA-01 | Steve Scalise | 49 |
| LA-03 | Clay Higgins | 27 |
Louisiana ranks #18 by FQHC patients and #9 by organization count among the 57 national-breadth states/territories (excludes California and Texas, which have dedicated dashboards). All 41 centers depend on the federal Community Health Center Fund, authorized only through December 31, 2026.
FQHC data from the HRSA bulk-sites file + UDS 2024 + IRS 990. State policy profile via NACHC/KFF/AANP. Intelligence items cite primary sources. Federal items apply to all states; state items are Louisiana-only. Updated 2026-06-03.