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.

One health policy professor said cutting Medicaid and similar programs "will be devastating" to millions of Americans.

The legislation increases the federal excise tax reimbursement on rum imported from Puerto Rico, imposes new limits on full access to Pell grants and restricts the island’s access to the opportunity z