Impact of Trump’s Medicaid Cuts: How Rural Americans Will Face the Consequences First

When Hurricane Helene hit western North Carolina last year, it surprised many. Floodwaters devastated communities, leaving some still recovering. Now, as lawmakers in Washington discuss a major reconciliation bill, folks in places like Asheville are anxious about what’s coming next.

Laurie Stradley, CEO of Impact Health in Asheville, highlighted a troubling fact: people often don’t see the danger until they’re affected. Her organization provides services to those caught in the aftermath of the flood, relying heavily on Medicaid.

Medicaid serves many in the U.S., covering 71 million low-income, disabled, and elderly residents. It supports half of all U.S. births and covers about 60% of nursing home residents’ care. Recent changes in federal funding have raised concerns. The bill proposes cuts of over $1 trillion to Medicaid, which could force states to drop essential healthcare services.

Joan Akler from Georgetown University’s Center for Children and Families calls the bill a significant step backward. “This rollback of healthcare is unprecedented,” she said. The cuts would favor wealthy individuals and corporations while leaving many without care.

The Medicaid expansion under the Affordable Care Act has allowed low-income families to access no-cost insurance, but it’s been contentious in several Republican-led states. In North Carolina, which just implemented its expansion in December 2023, experts estimate that $32 billion in federal funding could vanish in the next decade.

Kody Kinsley, North Carolina’s former secretary of health, pointed out a worrying “kill switch” in the legislation. If the state spends on the Medicaid expansion, it could automatically end the program. In less than 19 months since its launch, over 650,000 people have gained coverage through this expansion.

According to the Congressional Budget Office, around 17 million people nationwide may lose their insurance by 2034, with nearly 12 million losing it specifically due to Medicaid cuts. Nurse Molly Zenkler from Mission Hospital in Asheville expressed her fears: “Cuts to Medicaid will cost lives.”

The bill doesn’t just threaten patient care. It can put hospitals, especially in rural areas, at risk of closure. An analysis from the Sheps Center for Health Services Research reveals that hundreds of rural hospitals are at imminent risk due to proposed Medicaid cuts.

In Kentucky, where one-third of residents rely on Medicaid, the potential for hospital closures looms large. As many as 35 rural hospitals in the state could shut their doors. Arizona is similarly at risk; experts predict a loss of over $6 billion in the next seven years, leaving more than 55% of Arizona’s hospitals in jeopardy.

The complex U.S. healthcare system only adds to these concerns. Stradley notes that some rural residents don’t even realize they’re on Medicaid because of the various names used for state programs.

Local stories illustrate the real impact. Amanda Moynihan, a mother of three from Idaho, shared how Medicaid has transformed her life. Thanks to the support, she’s pursuing higher education and improving her family’s situation. Without it, her prospects would be grim.

In short, cuts to Medicaid have wide-reaching effects. They don’t just impact individuals; they threaten the healthcare infrastructure that many communities depend on. People like Moynihan serve as reminders of how essential these programs are — not just for health, but for overall stability and opportunity.

For more detailed information on Medicaid, you can check the American Hospital Association’s factsheet.

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