Trump's Tax Plan Could Leave Millions Uninsured, Hit Rural America Hard

Rural hospitals and health advocates warn that President Donald Trump’s proposed tax cuts and spending bill could threaten critical medical services in small towns nationwide.

Medicaid, which supports 71 million low-income Americans, is vital for rural areas where patients are typically older, sicker, and more reliant on government-funded care.

The legislation, which aims to extend the 2017 tax cuts, would slash Medicaid funding and impose stricter requirements for recipients — a move that providers say could force some facilities to cut services or shut down entirely.

Also Read: Trump’s New Order Targets Drug Pricing Transparency And Medicare Cost Reduction

The bill would reduce Medicaid spending by $785 billion over a decade, a key offset to the extended tax breaks that primarily benefit wealthier Americans.

Citing data from Georgetown University’s Center for Children and Families, Reuters reported that about 18% of adults in rural regions are enrolled in Medicaid, compared to 16% nationally.

The nonpartisan Congressional Budget Office estimates that the proposed legislation would leave nearly 11 million more uninsured over the next ten years.

House Speaker Mike Johnson (R-La.) defended Trump‘s “big, beautiful bill”, arguing that those who lose Medicaid will do so by personal choice.

Cuts would come from work requirements for adult recipients, restrictions on non-citizen coverage, and changes to how states account for their share of Medicaid spending.

These adjustments could severely impact states like Kansas, which recently raised its provider tax to draw more federal Medicaid funding. The bill would freeze such tactics, potentially cutting millions from hospital budgets.

The Senate has yet to act on the bill, and with a July 4 deadline looming, lawmakers are under pressure. Republicans, who hold a slim 53–47 majority, are divided.

Budget hawks push for deeper cuts, while senators from rural states — at least 41 of whom are Republicans — are concerned about the fallout in their districts.

Meanwhile, the bill’s sweeping cuts to foreign aid have also raised alarm. In a Reuters report, UNAIDS Executive Director Winnie Byanyima criticized the proposal for undermining the global fight against HIV/AIDS.

With 1.3 million new infections recorded in 2023 and South Africa heavily reliant on U.S. aid, she said the decision could derail the goal of ending the disease as a public health threat by 2030.

As debate intensifies, rural healthcare providers, solar-energy firms, and other affected industries continue lobbying to change the 1,100-page bill. But with little Democratic support and internal GOP disagreements, the path forward remains uncertain.

Read Next:

• RFK Jr. Appointee To CDC Advisory Committee Was A Paid Expert In Merck’s Gardasil Lawsuit

Photo: Shutterstock