The neediest people were let down again by the lawmakers they voted for. It's baffling.

Miami Herald

11-07-2025

Cathy Price's words stopped me cold. She's a 72-year-old woman who worked as a nurse at Martin General in a rural part of North Carolina. That area stands to be particularly hard hit by the 'big beautiful bill' Republicans passed and President Donald Trump signed into law on the 249th anniversary of this country's birth.
Martin General was part of ECU Health, a not-for-profit system that serves about 1.4 million people in eastern North Carolina, including rural areas in Martin County.
ECU planned to reopen Martin General, at least for emergency and some diagnostic services. It closed in 2023, then North Carolina finally agreed to expand Medicaid through the Affordable Care Act (Obamacare), giving residents hope their local hospital would return.
The nearest hospital is a 30- to 40-minute drive away.
'We're in a life-and-death crisis,' Price told The New York Times. 'People's lives are on the line because of the hospital not being here.'
She knows the dire situation facing rural residents in Martin County, and elsewhere. Still, she told The Times she supports President Trump's supposed efforts to rid Medicaid of fraud and waste.
What she and many other Trump supporters don't seem to understand is that in the eyes of Trump and most other Republicans in Washington, D.C. — including the ones rural North Carolina residents sent to the nation's capital to represent them — they are the fraud and waste.
They are the lazy 'able-bodied' people, supposedly addicted to government assistance, who hate having to take care of themselves.
They are the problem Republicans are trying to solve, the sacrifice the GOP just made to ensure the wealthiest Americans and corporations can receive yet another massive tax cut.
The wealthiest Americans did not need even more money in their pockets, but Price's neighbors and friends in Martin County need the health care that will be taken away, or may never materialize, because of the 'big beautiful bill' billionaire Trump can't stop crowing about.
The Medicaid coverage that, as recalled in The Times article, allowed 58-year-old Lori Kelley in Harrisburg to save a finger and detect two tumors? That might be going away. But at least private plane and yacht owners are gonna have yet another way to write off some of their tax obligations.
For decades now, rural residents have been flocking to the Republican Party. It's mostly been white rural residents, but a small but not-insignificant number of Black and brown rural residents have joined them. Theories abound as to why.
Political analysts will point to policies such as NAFTA, which has been blamed for the loss of manufacturing jobs in rural areas. I grew up in St. Stephen, S.C., and saw the Georgia Pacific paper plant that had sustained us close and leave a devastating void. At least four of my family members worked there. As a journalist, I documented the closing of a bevy of manufacturing plants, including International Paper and Georgetown Steel in Georgetown, and an electricity-producing plant in Conway.
The shifts in manufacturing are complex and multilayered. They've caused real harm to real people. But there is no one cause, which is why I don't believe that can explain the voting shifts.
And the two parties have been exceedingly clear about their priorities. When Democrats are given power, they fight to expand health care coverage, strengthen the safety net and argue for a living wage and higher taxes on the wealthy. The GOP does the opposite. (The same can be said of how the parties view disaster preparedness and assistance. The Trump administration is trying to dismantle FEMA even as natural disasters are causing even more harm and killing more people. Democrats want to better fund such agencies.)
During Trump's first term, one of the Republicans' top goals was to fully uproot Obamacare, risking the lives of tens of thousands of Americans and the health of millions. The 'big beautiful bill' helped the GOP partially accomplish that goal – at the expense of Price and her rural North Carolina neighbors.
It's one of the most baffling truisms of the modern political era. The neediest Americans repeatedly empower the people most likely to ignore their most-pressing needs.