Latest news with #healthcarecuts
The Independent
3 days ago
- Business
- The Independent
Joni Ernst doubles down on bleak ‘We are all going to die' comments in sarcastic non-apology
The senator went viral after she said, 'We all are going to die,' when responding to a question about the proposed cuts in President Donald Trump 's tax legislation during a town hall in Parkersburg on Friday. As Ernst began to answer the question, a person in the audience shouted, 'People will die!' "People are not — well, we all are going to die. For heaven's sakes, folks,' she said in response. Ernst shared a video on her Instagram story on Saturday where she spoke directly to the camera, seemingly from a cemetery. "Hello everyone. I would like to take this opportunity to sincerely apologize for a statement that I made yesterday at my town hall," said before going on to describe what happened. "I made an incorrect assumption that everyone in the auditorium understood that yes, we are all going to perish from this Earth," she added. "So I apologize. And I'm really, really glad that I did not have to bring up the subject of the tooth fairy as well.' "But for those that would like to see eternal and everlasting life, I encourage you to embrace my lord and savior, Jesus Christ," said Ernst. According to the Congressional Budget Office, the Republican tax bill will cut Medicaid spending by $723 billion over the next 10 years. The number of uninsured people could rise by as much as 7.6 million. During the town hall event in Parkersburg, Ernst argued that the goal of the legislation is to ensure that those not eligible for Medicaid don't get the benefits. "What you don't want to do is listen to me when I say that we are going to focus on those that are most vulnerable," she said. "Those that meet the eligibility requirements for Medicaid, we will protect. We will protect them. Medicaid is extremely important here in the state of Iowa. If you don't want to listen, that's fine." She subsequently went on to blame the "hysteria that's out there coming from the left" for the criticism of her initial statement. Former Republican Rep. Adam Kinzinger responded to Ernst's Instagram story on X, writing: 'Whelp. No sense of goodness left in her now.' 'I'm sorry… is she walking through a cemetery as she makes this?' Democratic strategist Tim Hogan added.
Yahoo
3 days ago
- Business
- Yahoo
How huge health funding cuts in Washington 'put lives at risk' in communities
CHARLOTTE, N.C. (AP) — Americans are losing a vast array of people and programs dedicated to keeping them healthy. Gone are specialists who were confronting a measles outbreak in Ohio, workers who drove a van to schools in North Carolina to offer vaccinations and a program that provided free tests to sick people in Tennessee. State and local health departments responsible for invisible but critical work such as inspecting restaurants, monitoring wastewater for new and harmful germs, responding to outbreaks before they get too big — and a host of other tasks to protect both individuals and communities — are being hollowed out. 'Nobody wants to go swim in a community pool and come out of it with a rash or a disease from it. Nobody wants to walk out their door and take a fresh breath of air and start wheezing,' said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials. But local health officials say they now have no choice but to do a lot less of it. The Trump administration is cutting health spending on an unprecedented scale, experts say, including pulling $11 billion of direct federal support because the pandemic is over, eliminating 20,000 jobs at national health agencies that in part assist and support local public health work. And it's proposing billions more be slashed. Together, public health leaders said, the cuts are reducing the entire system to a shadow of what it once was, threatening to undermine even routine work at a time when the nation faces the deadliest measles outbreak since at least the 1990s, rising whooping cough cases and the risk that bird flu could spread widely among people. The moves reflect a shift that Americans may not fully realize, away from the very idea of public health: doing the work that no individual can do alone to safeguard the population as a whole. That's one of the most critical responsibilities of government, notes James Williams, county executive in Santa Clara County, California. And it goes beyond having police and fire departments. 'It means not having babies suffering from diseases that you vanquished. It means making sure that people have access to the most accurate and up-to-date information and decisions that help their longevity,' Williams said. 'It means having a society and communities able to actually prosper, with people living healthy and full lives.' Keeping communities healthy saves lives — and money Just outside a Charlotte, North Carolina, high school in March, nurse Kim Cristino set out five vaccines as a 17-year-old girl in ripped jeans stepped onto a health department van. The patient barely flinched as Cristino gave her three shots in one arm and two in the other to prevent diseases including measles, diphtheria and polio. Like many other teens that morning, the girl was getting some shots years later than recommended. The clinic's appearance at Independence High School gave her a convenient way to get up to date. 'It lessens the barriers for parents who would have to be taking off from work and trying to get their kids to a provider,' Cristino said. The vaccinations also help the community around her. The teen won't come down with a life-threatening disease and the whole community is protected from outbreaks — if enough people are vaccinated. The Mecklenburg County department, with 'Protecting and Promoting the Public's Health' emblazoned on its van, is similar to other U.S. health departments. They run programs to reduce suicides and drug overdoses, improve prenatal health and help people stop smoking. They educate people about health and test for and treat diseases such as HIV and tuberculosis. Some, including Mecklenburg, operate medical and dental clinics too. 'You come to work every day and think: What's going to be my challenge today? Sometimes it's a new disease,' said Raynard Washington, Mecklenburg's director. 'That's why having a backbone infrastructure is so important.' What they do is cost-effective, experts have found. For every dollar spent on childhood immunizations, the country is estimated to save $11; on tobacco cessation, $2-$3; on asthma control, $70. Disease prevention is unseen — and ignored Critical care can be glamorous — surgeons, cardiologists and cancer doctors can pull off breathtaking medical feats to save lives at the last possible moment. Prevention work is low key. It's impossible to identify who was saved because, if it goes well, the person never knows when they've fended off a mortal threat with the invisible shield of public health. 'People don't appreciate it,' said Dr. Umair Shah, former health director for Washington state. 'Therefore, they don't invest in it.' State health departments are funded by a varying mix of federal and state tax money. Some states deliver services in a centralized way while others provide resources to local departments, which generally also get money from counties, cities or towns. Some large cities get direct federal funding for their health departments. Mecklenburg — a large department with around 1,000 workers serving 1.2 million people — has an annual budget of around $135 million, while some metro hospitals have operating expenses in the billions. About 70% of the department's budget comes from local funds, which helps fill gaps in state and federal money. But Mecklenburg is still strapped for cash and resources. At times, employees work 12- to 14-hour days, especially during outbreaks. Nurse Carmel Jenkins recalled responding to mpox exposures at a day care center — arriving before 5:30 a.m. to alert the children's parents and working late into the evening. 'Even though there may be limited resources, we still have a service to provide,' said Jenkins, a director of clinical services for the department. 'We don't mind going above and beyond to be able to do that.' Chaos in Washington puts 'lives at risk' In March, the Trump administration pulled $11 billion from state and local health departments without warning under the leadership of Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist and public health critic. The cuts abruptly ended COVID-era grants, which had also been approved for non-COVID work including vaccination and disease detection, tracking and testing. A week later, thousands of people were laid off at the Centers for Disease Control and Prevention. Many had worked closely with state and local health departments to provide information, grants and other support. The sudden, one-two punch delivered a serious blow to the system, public health leaders said in interviews, court filings and public testimony. A Kennedy spokesman said in an email that America remains unhealthy compared with other developed nations and HHS is reorganizing what he said were 'broken systems' and reprioritizing resources to 'centralize programs and functions that will improve our service to the American people.' 'These cuts are not about abandoning public health — they're about reforming it,' spokesman Andrew Nixon said, adding: 'We reject the implication that HHS has turned its back on urgent health threats.' HHS justified the grant cancellations by saying the money was for COVID and the pandemic is over. But most of the cuts were in areas that are especially important given today's health threats. The biggest chunk, more than $8.9 billion, involved epidemiology and laboratory capacity related to infectious diseases, while another $2 billion was related to immunizations. In some places, the cuts are on hold due to a federal judge's order in a lawsuit by states. But elsewhere, cuts are continuing. In Mecklenburg, for example, 11 community health workers lost their jobs, meaning less outreach to groups like the Hispanic community. All eight employees dedicated to the mobile vaccine program were laid off. In Columbus, Ohio — one of several communities in Republican-led states suing over the cuts — the health department had to lay off nine disease intervention specialists. This left it operating at 25% capacity in its disease tracing and investigation work just as it prepared to address a measles outbreak. Kansas City, Missouri, will not be able to do its own testing for infectious diseases because the cut came just as the city was about to buy $500,000 worth of equipment. And Nashville had to end a program offering free flu and COVID tests and cancel plans to buy a van to deliver vaccinations. The cities complained the cuts had created 'severe budget uncertainty' and forced them to redirect their limited resources 'to respond to the resulting chaos.' CDC staff cuts are also having a ripple effect on state and local departments. Children who are deaf or hard of hearing will no longer benefit from an early intervention program run by states after everyone who worked on the program at CDC was laid off. The team in the Office on Smoking and Health, which funds state tobacco hotlines that help people quit, was let go. So was the CDC team that worked to reduce drownings, partly through funding low-cost swimming lessons in local communities. Drownings kill 4,000 people a year in the U.S. 'The experts who know the things that can be done to help prevent the No. 1 cause of death from children ages 1 to 4 have been eliminated,' Connecticut state health commissioner Dr. Manisha Juthani told a Democratic congressional hearing in April, referring to drownings. She said the abrupt and disorganized nature of the cuts leaves her department scrambling as officials try to understand what is being cut and to close important programs on the federal government's impractical timelines. 'The current uncertainty puts lives at risk,' she said. Public health funding is going bust — and about to get worse The new cuts are especially damaging because health departments are funded differently than other government agencies meant to protect the public: Funding pours in during emergencies and slows to a relative trickle when they subside. Mecklenburg's Washington notes the contrast with fire departments, which are kept ready at all times, not scrambling to find firefighters and fire trucks when houses are already burning. With health departments, 'there's a long-established pattern of boom-and-bust funding,' said Dr. Steven Stack, Kentucky's public health commissioner and past president of the Association of State and Territorial Health Officials. A temporary surge of money during the pandemic allowed some health departments to expand and strengthen programs. In Alabama, the influx of COVID money allowed the state to reopen a health department in largely rural Coosa County that closed a decade ago due to a lack of money. In California's Santa Clara County, a COVID-era lab grant paved the way for a new science branch with nearly 50 positions. But by early this year, most of that money had disappeared, along with other COVID-era grants across the nation — some because they ended and some because the government rescinded them. Departments were again left brittle and vulnerable. 'We're facing funding cliff after funding cliff after funding cliff,' said Dr. Sara Cody, Santa Clara County's health director. 'What really worries me is I felt that we had finally built the infrastructure in the public health department. ... We were still pretty trim, but we weren't just, like, bones.' In Chicago, one-time COVID grants made up 51% of the health department budget, and their ending will push staff numbers below the pre-pandemic level of 588 — slowing responses to outbreaks and forcing officials to scale back food safety, violence prevention and other programs. In Mecklenburg, the department lost 180 employees as COVID funds dried up. It also lost a wastewater monitoring partnership with the University of North Carolina at Charlotte that helped the county react quickly to changing COVID variants and could have also been used to detect new threats like bird flu. The cuts are not over. The Trump administration has proposed cutting billions more from CDC's budget, enough to cut the agency's spending in half. CDC sends about 80 percent of its budget to states and local communities. Michael Eby, director of clinical services in Mecklenburg, said the relentless cuts to the system leave departments unable to respond to new pandemics and old diseases returning across the United States. 'Without the appropriate funding, we can't properly address these threats,' he said. 'We're at risk of them getting out of control and really causing a lot of damage and death to individuals that we could have saved, that we could have protected.' ___ Ungar reported from Charlotte and Louisville, Kentucky, and Smith reported from Providence, Rhode Island. Associated Press reporters Mary Conlon in Washington and Kenya Hunter in Atlanta contributed to this report. ——— The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
The Independent
3 days ago
- Business
- The Independent
How huge health funding cuts in Washington 'put lives at risk' in communities
Americans are losing a vast array of people and programs dedicated to keeping them healthy. Gone are specialists who were confronting a measles outbreak in Ohio, workers who drove a van to schools in North Carolina to offer vaccinations and a program that provided free tests to sick people in Tennessee. State and local health departments responsible for invisible but critical work such as inspecting restaurants, monitoring wastewater for new and harmful germs, responding to outbreaks before they get too big — and a host of other tasks to protect both individuals and communities — are being hollowed out. 'Nobody wants to go swim in a community pool and come out of it with a rash or a disease from it. Nobody wants to walk out their door and take a fresh breath of air and start wheezing,' said Lori Tremmel Freeman, executive director of the National Association of County and City Health Officials. But local health officials say they now have no choice but to do a lot less of it. The Trump administration is cutting health spending on an unprecedented scale, experts say, including pulling $11 billion of direct federal support because the pandemic is over, eliminating 20,000 jobs at national health agencies that in part assist and support local public health work. And it's proposing billions more be slashed. Together, public health leaders said, the cuts are reducing the entire system to a shadow of what it once was, threatening to undermine even routine work at a time when the nation faces the deadliest measles outbreak since at least the 1990s, rising whooping cough cases and the risk that bird flu could spread widely among people. The moves reflect a shift that Americans may not fully realize, away from the very idea of public health: doing the work that no individual can do alone to safeguard the population as a whole. That's one of the most critical responsibilities of government, notes James Williams, county executive in Santa Clara County, California. And it goes beyond having police and fire departments. 'It means not having babies suffering from diseases that you vanquished. It means making sure that people have access to the most accurate and up-to-date information and decisions that help their longevity,' Williams said. 'It means having a society and communities able to actually prosper, with people living healthy and full lives.' Keeping communities healthy saves lives — and money Just outside a Charlotte, North Carolina, high school in March, nurse Kim Cristino set out five vaccines as a 17-year-old girl in ripped jeans stepped onto a health department van. The patient barely flinched as Cristino gave her three shots in one arm and two in the other to prevent diseases including measles, diphtheria and polio. Like many other teens that morning, the girl was getting some shots years later than recommended. The clinic's appearance at Independence High School gave her a convenient way to get up to date. 'It lessens the barriers for parents who would have to be taking off from work and trying to get their kids to a provider,' Cristino said. The vaccinations also help the community around her. The teen won't come down with a life-threatening disease and the whole community is protected from outbreaks — if enough people are vaccinated. The Mecklenburg County department, with 'Protecting and Promoting the Public's Health' emblazoned on its van, is similar to other U.S. health departments. They run programs to reduce suicides and drug overdoses, improve prenatal health and help people stop smoking. They educate people about health and test for and treat diseases such as HIV and tuberculosis. Some, including Mecklenburg, operate medical and dental clinics too. 'You come to work every day and think: What's going to be my challenge today? Sometimes it's a new disease,' said Raynard Washington, Mecklenburg's director. 'That's why having a backbone infrastructure is so important.' What they do is cost-effective, experts have found. For every dollar spent on childhood immunizations, the country is estimated to save $11; on tobacco cessation, $2-$3; on asthma control, $70. Disease prevention is unseen — and ignored Critical care can be glamorous — surgeons, cardiologists and cancer doctors can pull off breathtaking medical feats to save lives at the last possible moment. Prevention work is low key. It's impossible to identify who was saved because, if it goes well, the person never knows when they've fended off a mortal threat with the invisible shield of public health. ' People don't appreciate it,' said Dr. Umair Shah, former health director for Washington state. 'Therefore, they don't invest in it.' State health departments are funded by a varying mix of federal and state tax money. Some states deliver services in a centralized way while others provide resources to local departments, which generally also get money from counties, cities or towns. Some large cities get direct federal funding for their health departments. Mecklenburg — a large department with around 1,000 workers serving 1.2 million people — has an annual budget of around $135 million, while some metro hospitals have operating expenses in the billions. About 70% of the department's budget comes from local funds, which helps fill gaps in state and federal money. But Mecklenburg is still strapped for cash and resources. At times, employees work 12- to 14-hour days, especially during outbreaks. Nurse Carmel Jenkins recalled responding to mpox exposures at a day care center — arriving before 5:30 a.m. to alert the children's parents and working late into the evening. 'Even though there may be limited resources, we still have a service to provide,' said Jenkins, a director of clinical services for the department. 'We don't mind going above and beyond to be able to do that.' Chaos in Washington puts 'lives at risk' In March, the Trump administration pulled $11 billion from state and local health departments without warning under the leadership of Health Secretary Robert F. Kennedy Jr., a longtime anti-vaccine activist and public health critic. The cuts abruptly ended COVID-era grants, which had also been approved for non-COVID work including vaccination and disease detection, tracking and testing. A week later, thousands of people were laid off at the Centers for Disease Control and Prevention. Many had worked closely with state and local health departments to provide information, grants and other support. The sudden, one-two punch delivered a serious blow to the system, public health leaders said in interviews, court filings and public testimony. A Kennedy spokesman said in an email that America remains unhealthy compared with other developed nations and HHS is reorganizing what he said were 'broken systems' and reprioritizing resources to 'centralize programs and functions that will improve our service to the American people.' 'These cuts are not about abandoning public health — they're about reforming it,' spokesman Andrew Nixon said, adding: 'We reject the implication that HHS has turned its back on urgent health threats.' HHS justified the grant cancellations by saying the money was for COVID and the pandemic is over. But most of the cuts were in areas that are especially important given today's health threats. The biggest chunk, more than $8.9 billion, involved epidemiology and laboratory capacity related to infectious diseases, while another $2 billion was related to immunizations. In some places, the cuts are on hold due to a federal judge's order in a lawsuit by states. But elsewhere, cuts are continuing. In Mecklenburg, for example, 11 community health workers lost their jobs, meaning less outreach to groups like the Hispanic community. All eight employees dedicated to the mobile vaccine program were laid off. In Columbus, Ohio — one of several communities in Republican-led states suing over the cuts — the health department had to lay off nine disease intervention specialists. This left it operating at 25% capacity in its disease tracing and investigation work just as it prepared to address a measles outbreak. Kansas City, Missouri, will not be able to do its own testing for infectious diseases because the cut came just as the city was about to buy $500,000 worth of equipment. And Nashville had to end a program offering free flu and COVID tests and cancel plans to buy a van to deliver vaccinations. The cities complained the cuts had created 'severe budget uncertainty' and forced them to redirect their limited resources 'to respond to the resulting chaos.' CDC staff cuts are also having a ripple effect on state and local departments. Children who are deaf or hard of hearing will no longer benefit from an early intervention program run by states after everyone who worked on the program at CDC was laid off. The team in the Office on Smoking and Health, which funds state tobacco hotlines that help people quit, was let go. So was the CDC team that worked to reduce drownings, partly through funding low-cost swimming lessons in local communities. Drownings kill 4,000 people a year in the U.S. 'The experts who know the things that can be done to help prevent the No. 1 cause of death from children ages 1 to 4 have been eliminated,' Connecticut state health commissioner Dr. Manisha Juthani told a Democratic congressional hearing in April, referring to drownings. She said the abrupt and disorganized nature of the cuts leaves her department scrambling as officials try to understand what is being cut and to close important programs on the federal government's impractical timelines. 'The current uncertainty puts lives at risk,' she said. Public health funding is going bust — and about to get worse The new cuts are especially damaging because health departments are funded differently than other government agencies meant to protect the public: Funding pours in during emergencies and slows to a relative trickle when they subside. Mecklenburg's Washington notes the contrast with fire departments, which are kept ready at all times, not scrambling to find firefighters and fire trucks when houses are already burning. With health departments, 'there's a long-established pattern of boom-and-bust funding,' said Dr. Steven Stack, Kentucky's public health commissioner and past president of the Association of State and Territorial Health Officials. A temporary surge of money during the pandemic allowed some health departments to expand and strengthen programs. In Alabama, the influx of COVID money allowed the state to reopen a health department in largely rural Coosa County that closed a decade ago due to a lack of money. In California's Santa Clara County, a COVID-era lab grant paved the way for a new science branch with nearly 50 positions. But by early this year, most of that money had disappeared, along with other COVID-era grants across the nation — some because they ended and some because the government rescinded them. Departments were again left brittle and vulnerable. 'We're facing funding cliff after funding cliff after funding cliff,' said Dr. Sara Cody, Santa Clara County's health director. 'What really worries me is I felt that we had finally built the infrastructure in the public health department. ... We were still pretty trim, but we weren't just, like, bones.' In Chicago, one-time COVID grants made up 51% of the health department budget, and their ending will push staff numbers below the pre-pandemic level of 588 — slowing responses to outbreaks and forcing officials to scale back food safety, violence prevention and other programs. In Mecklenburg, the department lost 180 employees as COVID funds dried up. It also lost a wastewater monitoring partnership with the University of North Carolina at Charlotte that helped the county react quickly to changing COVID variants and could have also been used to detect new threats like bird flu. The cuts are not over. The Trump administration has proposed cutting billions more from CDC's budget, enough to cut the agency's spending in half. CDC sends about 80 percent of its budget to states and local communities. Michael Eby, director of clinical services in Mecklenburg, said the relentless cuts to the system leave departments unable to respond to new pandemics and old diseases returning across the United States. 'Without the appropriate funding, we can't properly address these threats,' he said. 'We're at risk of them getting out of control and really causing a lot of damage and death to individuals that we could have saved, that we could have protected.' ___ Ungar reported from Charlotte and Louisville, Kentucky, and Smith reported from Providence, Rhode Island. Associated Press reporters Mary Conlon in Washington and Kenya Hunter in Atlanta contributed to this report. ——— The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute's Science and Educational Media Group and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.
CBS News
22-05-2025
- Health
- CBS News
Michigan organizations speak on possible impact of federal Medicaid cuts
House Republicans are debating a federal spending bill that would cut at least $880 billion over the next 10 years from energy and health care programs, like Medicaid. Metro Detroit organizers, including Danielle Atkinson with Mothering Justice, say those decisions could have major local impacts. "When we're talking about these cuts, these drastic cuts, we're talking about really the difference between thriving and surviving," said Atkinson. The Trump administration's "big, beautiful bill" looks to offer nearly $4.5 trillion in tax breaks. If the law passes Congress, it could freeze the proposed provider tax that some states use to help pay for large portions of their Medicaid programs. A Michigan Department of Health and Human Services report found that if the cuts go through, nearly 750,000 Michiganders could lose their healthcare coverage. "Your access to healthcare in this country is facilitated by your insurance coverage, and your ability to have healthcare and be healthy completely affects your ability to participate in economic, social, and civic life, and have equal opportunity," said Merissa Kovach, political director at ACLU Michigan. Organizers say the demographics most at risk with the cuts are already some of our most vulnerable: pregnant women, people with disabilities and seniors. "We have to make sure that healthcare is affordable, accessible, and that there aren't barriers to entry," said Atkinson. With one in four Michiganders on Medicaid, Kovach says a slash in government funds could place a massive strain on an already struggling health system. "We will see hospitals close, and that is going to be many hundreds of thousands of Michiganders' direct line to being able to access healthcare," said Kovach. "If we can't take care of ourselves, if we can't take care of our children, we're looking at just a really horrible future," said Atkinson. While lawmakers are discussing the bill on the congressional floor, it is unknown if it will make it out of the House chamber before Speaker Mike Johnson's Memorial Day deadline.
The Guardian
16-05-2025
- Politics
- The Guardian
In California's deep-red north, voters startled by pace of cuts – but they're still backing Trump
Donald Trump's administration has sought to remake the federal government at a breakneck pace. In far northern California – where he has strong support – people have backed those efforts. But even here, the speed and scale of the president's agenda has been cause for concern. Officials in Shasta county, a region of 180,000 perhaps best known in recent years for its turbulent far-right politics, recently voted unanimously to send a letter to the federal government expressing concern about how layoffs could affect the nearby Whiskeytown national recreation area, which brings as much as $80m to the local economy each year. 'The board urges the administration to reconsider layoffs impacting the National Park Service,' the letter states. 'National parks, recreation areas, lakes, and mountainous regions throughout this great nation may be adversely impacted if not adequately protected and maintained for all to enjoy, both in the immediate future, and for years to come.' In March, about 150 people took to the streets in Redding, the Shasta county seat, to protest proposed cuts to the Department of Veterans Affairs. A month later more than 1,000 people in the area gathered to demonstrate against the administration's policies. Amid reports about possible reductions to Medicaid, the head of the area's largest healthcare provider warned such action could have 'crippling' impacts in a county where the local medicaid provider serves nearly a third of the population. A bipartisan group of state lawmakers, including the region's Republican representatives, signed a letter in late April urging Congress to protect Head Start, the federally funded education program. While California remains a Democratic stronghold, its less densely populated interior swings decidedly more conservative, with deep red enclaves in the state's far north that have been particularly supportive of Trump. In Shasta county, where the president visited during his 2016 campaign, 67% of voters voted for Trump in November. Nearby counties, including Tehama, Lassen and Modoc, backed Trump at even greater levels. Support for Trump's agenda has remained strong among Republicans in California. While 68% of California voters reported they disapprove of Trump's performance and just 30% approve, 75% of Republicans say they approve, according to a new Berkeley IGS poll. The poll also found that 69% of California Republicans think the country is now headed in the right direction, a major shift from last year when 93% believed it was headed in the wrong direction. That's the case, too, in rural California, where many voters said they backed the Trump administration's policies, including tariffs against other countries, a smaller federal government, and, they hoped, reduced prices and a stronger economy. But the unease in an area where the president is still deeply popular highlights the potential effects the cuts pose to the region – particularly its rural communities – that is more reliant on federal support on everything from infrastructure to emergency preparedness to healthcare and childcare. 'These cuts may, in fact, hurt rural communities harder because they just don't have their tax bases,' said Lisa Pruitt, a rural law expert at the University of California, Davis. 'Their bandwidth for providing all sorts of services are just much weaker to begin with, and that makes them more reliant on federal monies.' For some in this part of California the outcomes, and rapid pace at which the administration has moved, have been startling. It was what Morgan Akin, a Shasta county resident and US marine veteran who joined the March protest against the VA cuts, expected would happen when Trump took office. 'They're predicting 80,000 cuts on the VA. That's going to have an effect on the veterans throughout the country,' said Akin. 'All these federal employees have just been dumped.' He added: 'It's been a shock, and I think that's what's disrupting for most people.' Bruce Ross, a Shasta county Republican, acknowledged the difficulties of seeing layoffs, but said he has been pleased with the direction of the administration. 'Everybody who lives up in north-eastern California knows folks who work for the Forest Service, or for federal agencies, and it's tough for them. I think on a human level, that's real,' Ross said. But, he added, he has seen a willingness on the part of the administration to listen when local officials have pushed back against proposed cuts, and the practical changes have ultimately, so far, been less severe than they initially seemed. 'There's been a lot of drama about it. But I think the actual results have shown that the administration is listening to people and saying, OK, this is important. We're gonna take it back.' Congressman Doug LaMalfa, a Republican and staunch Trump supporter who represents a large swath of northern California's interior, has acknowledged that some of his constituents, and Republicans broadly, are concerned, but echoed Ross's sentiments. 'But they're listening to us. I got in a room with Elon [Musk] and his right-hand man. They're understanding us now, and they're going to look at it more through that lens, and they'll certainly listen to us,' he told the Chico Enterprise-Record in March. In that interview, he pushed back against talk of broad layoffs and cuts to key programs. 'There is no social security cuts. There is no cuts to the VA system; the employee stuff, we've still got more work to do with that.' Ross, who is also the secretary for the Shasta county Republican central committee, admitted there will likely be pain as Trump enacts his agenda, but argued that was necessary to tackle the federal deficit. 'There's a $2tn annual deficit with the federal government in Washington in a time of peace and a fairly strong economy,' he said. 'How do you ever go about trying to balance that without being somewhat aggressive about actually cutting spending? It's never going to be easy to do.' Steve Barkley, a 74-year-old who lives in northern California's Sierra foothills, said he felt confident in the president's agenda, and wasn't worried about any cuts to Medicare or social security. 'He's the first candidate that was really saying the things that I wanted to hear, and promised to do the things that I want it done, and he's keeping his promises,' Barkley said, adding that he believed Trump's recent actions ensure the longevity of those programs and boost the economy. 'I'm happy. I don't expect anything to get done right away. It's going to take time.' Ross is hopeful that even with some short-term pain, Trump's policies will ultimately improve the region. He pointed to the area's recent history of massive destructive and deadly wildfires and the lack of land management in federal forests that has contributed to such blazes. He would like to see the return of the timber industry, which was historically a major employer in the area, and believes that could be possible under the new administration. 'I think that's going to be good for northern California. It's not just about money – it's about what is their direction, and what are their goals? And just bluntly, they're on our side,' he said. 'And again, look at the federal deficits and explain how that's sustainable, and explain how that's going to change in a way that doesn't cause some dissension. It's hard on any level. But I think long-term, it's what the country needs.'
