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1A

ICYMI: The Megabill, Medicaid And Rural Americans

1A

NPR

News

4.44.3K Ratings

🗓️ 7 July 2025

⏱️ 12 minutes

🧾️ Download transcript

Summary

On Friday, President Donald Trump celebrated the passage of his signature tax and spending bill into law.

At nearly 900 pages, the legislation is a sprawling collection of tax breaks, spending cuts and other Republican priorities, including new money for national defense and deportations. It will also reduce Medicaid spending by more than $1 trillion over the next decade. That will result in an estimated 11.8 million people losing health insurance coverage. Among those who will be hardest hit? Rural Americans.

We discuss what kind of challenges people living in rural areas could face with the new law and what ripple effects the law could have across rural public health systems.

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Transcript

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0:00.0

You're listening to the 1A podcast. I'm Jen White, and this is, in case you missed it,

0:12.3

where we bring you some of the week's most important conversations you might have missed.

0:16.3

In Washington, on Friday, President Donald Trump celebrated the passage of his signature tax and spending bill into law.

0:23.0

That's after House Republicans muscled it through Congress meeting their self-imposed 4th of July deadline.

0:28.4

At nearly 900 pages, the legislation is a sprawling collection of tax breaks, spending cuts, and other Republican priorities,

0:35.9

including new money for national defense and deportations.

0:39.0

It will also reduce Medicaid spending by more than $1 trillion over the next decade.

0:44.5

That will result in an estimated 11.8 million people losing health insurance coverage,

0:49.4

according to KFF News. Among those hardest hit, rural Americans.

0:57.0

Here's Kentucky Governor Andy Bashir, a Democrat,

1:02.6

speaking to CNN's Dana Bash. His state is one of the 40 that expanded Medicaid under the Affordable Care Act in 2010. About one-third of Kentucky residents are on Medicaid.

1:07.7

Well, this law is devastating. It's the single worst piece of legislation I've seen in my lifetime, and it is a congressional,

1:14.6

Republican and presidential attack on rural America.

1:18.6

In my state alone, 200,000 people are going to lose their coverage.

1:22.6

Those are 200,000 Kentuckians that deserve to see a doctor when they're sick.

1:28.2

20,000 healthcare workers are going to lose their jobs.

1:31.6

And we've got up to 35 rural hospitals that are typically the second biggest employer in their communities that may close their doors.

1:39.9

And what that means is our economy takes a huge hit.

1:43.3

And then whether you have private insurance or Medicaid, if you live in rural America,

1:47.3

you have to drive hours just to see the doctor that used to be in your community.

1:52.9

That was Kentucky's Democratic Governor Andy Bashir on CNN this weekend.

1:57.4

What kind of challenges could people living in rural areas face under the new law and what

...

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