One Rural Doctor on the Cuts to Medicaid

When Republicans passed their big domestic policy bill just over a week ago, they kept making the same argument about sweeping changes to Medicaid: that the measures, including new work requirements, would encourage able-bodied adults to earn their health care, ultimately creating a fairer system for everyone. Critics said the opposite: they have predicted that millions of working people who need health care will lose it.

The truth will emerge in rural and often Republican-voting areas where cuts to Medicaid funding will be felt most deeply. Natalie Kitroeff spoke to a family doctor in one of those places, western North Carolina, about what she thinks will happen to her patients.

Guest: Shannon Dowler, a family physician and health advocate in western North Carolina.

Background reading: 

• In North Carolina, President Trump’s domestic policy law jeopardizes plans (https://www.nytimes.com/2025/07/06/us/north-carolina-medicaid-cuts.html) to reopen one rural county’s hospital — and health coverage for hundreds of thousands of state residents.
• The nonpartisan Congressional Budget Office predicted that the Senate’s version of Trump’s bill would mean that 11.8 million more Americans would become uninsured (https://www.nytimes.com/2025/06/29/us/politics/trump-policy-bill-health-insurance-cuts.html) by 2034.

For more information on today’s episode, visit nytimes.com/thedaily (http://nytimes.com/thedaily?smid=pc-thedaily) . Transcripts of each episode will be made available by the next workday. 

Photo: Kaoly Gutierrez for The New York Times

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