Joe Sanka and Sylvia Goodman are both Kentucky natives, but neither of them had spent too much time in eastern Kentucky or Perry County before their recent reporting trip for Kentucky Public Radio.

They went looking for people to talk to them about the budget reconciliation bill, or as President Trump calls it, the big beautiful bill, which passed in the U.S. House last month.

More specifically, they wanted to talk to people about

the Medicaid cuts it proposes. How they would affect the health care industry, the various groups that

are trying to help people in this region access food, access health care, how it would affect

things like opioid treatment. You know, this is one of the epicenters of the opioid epidemic.

So we're just hoping to figure out exactly how providers are looking at some of these proposed

cuts.

Providers like Tanya Brock.

She worked as a nurse in the Appalachian region for decades and now serves on the boards of

the Kentucky Rural Health Association and the National

Association of Rural Health Clinics.

I've never seen as much concern and turmoil in health care as what I'm seeing now, and I've

been doing this since 1978.

And in the case of Perry County, Kentucky, the effects could be bigger than just insurance.

Greg Burke runs a substance abuse rehab center, and he told Sylvia and Joe a concern they heard

again and again, that the work requirements the bill would put in place could have broader

ripples of not just knocking people off Medicaid, but destabilizing an already fragile community.

Listen, I'm going to tell you right now, you take Medicaid away from this area, and it's nothing to dust.

You've got to be left with basically abandoned little towns and probably some very, very sick people.

Consider this. Sometimes to understand a big bill, it helps to go small. For our

reporter's notebook series, we are zooming in on what Republicans proposed Medicaid cuts could mean

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