A tiny county that overwhelmingly voted for Donald Trump has now been doomed by his flagship policy that threatens to wipe healthcare from millions.
A staggering 85 percent of Knox County, Kentucky, backed the Republican president in the election in November, with just 14 percent wanting Kamala Harris sworn in.
But just eight months later, they may be regretting it, as his Big Beautiful Bill, which passed on Independence Day, looks set to tear apart their everyday lives.
The policy is set to strip $1trillion from Medicaid, leaving an estimated 17million Americans without insurance by 2027 and it could decimate healthcare systems in rural areas, like Knox.
The county, which has a population of 30,000, has 38 percent of its total population on the system, including over 7,000 children.
Locals are now feeling betrayed by the Commander-in-Chief, who promoted the bill as a ‘win for workers, farmers, and America’s future.’
Dr. Osama Hashmi, a dermatologist in Atlanta, told the Daily Mail: ‘People think of healthcare as a free-market system and it’s really not. It affects everybody.’
A staggering 85 percent of Knox County in Kentucky backed the president in the election in November, with just 14 percent wanting Kamala Harris sworn in
Donald Trump’s massive bill, which adds trillions to the national debt, was passed on Independence Day, but for 17million Americans, there was no celebration. Congress just passed a bill that will striped $1trillion from Medicaid
Congress just passed a bill that will strip $1trillion from Medicaid and leave millions without insurance. It has the potential to decimate healthcare systems in rural areas, like Knox County, Kentucky, which has a population of 30,000
For Knox County resident Teresa McNab, whose husband fell ill and fatally started seizing on the floor of their home in 2021, Medicaid helped save their family.
Now, she and her daughter’s coverage is being threatened by Trump’s prized bill, which requires workers to work at least 80 hours per month to qualify for it.
For the line cook, who also cares for her mother, it’s nearly impossible, she told The Telegraph.
‘I take care of my daughter, I take care of my 78-year-old mom, I take care of our home, and half the time I don’t even have time for myself,’ she said.
For Lisa Garrison, she would not have been able to afford her daughter’s eye condition that would have cost her $180,000 without Medicaid.
‘You will be left without hospitals that can serve you near the hollers, without affordable or state-provided healthcare and SNAP benefits will also be affected.’
She added on her Facebook page earlier this month: ‘This bill is atrocious and dangerous. This bill will cause people to die.’
Hashmi agrees, adding to the Daily Mail that it will ‘100 percent lead to death.’
Kentucky faces the highest number of rural hospital closures in the country due to the bill, which will cut $28million from the Bluegrass State’s program in 10 years.
For Knox County resident, Teresa McNab, whose husband fell fatally in 2021, Medicaid helped save their family from drowning under the weight of medical bills. For Lisa Garrison, she wouldn’t have been able to afford her daughter’s condition that would have cost her $180,000
Thirty-five hospitals in Kentucky are at risk, Democrat Governor Andy Beshear said, and 200,000 in the state could lose coverage.
The Center for Healthcare Quality and Payment Reform found that the Bluegrass State has 19 hospitals that already have ‘losses on services’, which will only get worse when hospitals have to eat the cost of Medicaid cuts for patients unable to pay.
It also found that 16 are definitely at risk of closing, with four at the immediate risk level, a June 2025 report found.
‘This bill risks 200,000 Kentuckians’ lives, the jobs of 20,000 healthcare workers, 35 rural hospitals, and our economy,’ the governor said in a statement. ‘The passage of the ‘big, ugly bill’ marks a sad day for our country and commonwealth.
‘Kentucky deserves better.’
The Medicaid cuts don’t go into effect until January 1, 2027, but Hashmi said recipients will feel the effects much sooner and possibly within the next 12 months.
Hospitals and other healthcare providers in Atlanta, where he works, have already begun discussing whether or not they will continue to accept Medicaid as they ‘decrease [their] reliance’ on it ahead of the upcoming federal funding losses.
‘That planning starts now,’ Hashmi, who volunteers and works at a private practice, said. ‘Patients will see the effects in 12 months.’
Eighty-five percent of the small county, located near the Kentucky-Tennessee border, voted for Donald Trump in the 2024 presidential election (pictured: Barbourville in Knox County)
One percent voted for now-Health Secretary Robert F. Kennedy Jr . and 14 percent voted for Kamala Harris (pictured: Barbourville in Knox County)
Although those who lose their coverage will feel the effects the fastest, the federal cuts also hurt those using private insurance.
As hospitals and doctors’ offices close in rural areas, patients will be forced to go to urban areas and even metropolises to receive care, which ups wait times, decreases the quality of care as doctors have to see more patients, and threatens the infrastructure of healthcare.
‘We already have an access problem in the US,’ Hashmi said.
More so: ‘We all pay into this,’ the dermatologist said. Without federal funding, the states will have to subsidize hospitals to keep them afloat or the facilities risk bankruptcy.
This means the 50 states, especially those that heavily rely on Medicaid funding, will have to raise taxes for residents.
‘State systems are going to be severely disrupted,’ Hashmi said.
The debt hospitals take on for low-income patients will also rise, not just because ill person cannot pay them, but they will now take longer to seek care.
This means, when they do seek medical attention, they’ll be in later stages of diseases and illnesses that will require more advanced care, especially for cancer patients, who might seek help after it’s too late.
‘People think healthcare of a free-market system and it’s really not,’ Dr. Osama Hashmi, a board-certified dermatologist in Atlanta and co-founder of Impiricus, told Daily Mail. ‘It affects everybody’
Governor Andy Beshear condemned the bill, saying it risks 35 hospitals in Kentucky and 200,000 residents could lose their insurance. ‘Kentucky deserves better,’ he said
Hashmi said he has many patients where he can cure their skin cancer by simply removing it if it’s detected early, but for those who wait longer, it might not be so simple.
He fears more Medicaid patients will wait until it’s an emergency to seek help.
‘I think they should be really worried,’ he said of the cuts.
Miller Morris, a women’s health researcher, said: ‘Medicaid isn’t just a line item, it’s a lifeline.’
And the cuts affect organizations like Planned Parenthood, which provides STD testing, prenatal and postpartum services, and birth control to patients.
‘Cutting these services means millions of low-income women, especially in rural areas, will lose access to basic, often life-saving care.’
Leadership Consultant, Harold Reynolds, of Chicago, who works with clients in rural areas, called the bill a ‘$1trillion mistake.’
‘Whether the motive is fiscal conservatism or opposition to the [Affordable Care Act], the result of these cuts is not a more efficient system. It’s a more fragile one,’ he told Daily Mail.
Miller Morris, a women’s health researcher, said: ‘Medicaid isn’t just a line item, it’s a lifeline.’ Leadership Consultant, Harold Reynolds, agreed, saying: ‘Gutting it weakens the whole system’
And if rural communities are impacted significantly more than urban and cities, it could become a legal problem for the Trump Administration if they’re accused of discrimination, Attorney Ben Michael, of Michael & Associates, told Daily Mail
‘We’re not just talking about trimming excess, we’re pulling funding from hospitals and providers that serve everyone.’
Many experts also told the Daily Mail that the miseducation surrounding Medicaid – which is also called Obamacare – very much could have played a role in the support and confusion surrounding this bill.
Many people whose healthcare was threatened under the bill had no idea, as they didn’t realize their services were Medicaid, which now risks the health and safety of children, adults, and the elderly.
‘Supporters justify this by pointing to $56billion in ‘improper payments’ in 2023. But what they don’t explain is that the vast majority of those payments are not fraud,’ Reynolds said.
‘According to federal data, only about 1-4 percent of those improper payments are suspected fraud. The rest are paperwork errors, billing mismatches, or technical violations.
‘What’s really being cut is the funding that pays for maternity wards, ambulance services, emergency rooms, and nursing home care. Medicaid isn’t just a benefit for the poor. It’s a revenue stream for hospitals, clinics, and long-term care facilities.
‘Gutting it weakens the whole system,’ Reynolds concluded.
And if rural communities are impacted significantly more than urban areas and cities, it could become a legal problem for the Trump Administration, Attorney Ben Michael, of Michael & Associates, told Daily Mail.
‘With eligibility requirements becoming stricter, and if rural areas are more negatively impacted as others, that may be grounds for legal action in regard to discrimination,’ he said.
But for now, Americans brace for the inevitable and pray for a more equitable solution.
