It’s one of life’s sick ironies that many of the people who suffer most under Donald Trump are his most passionate supporters. This shouldn’t be surprising: rural Americans enthusiastically voting against their interests has been the bedrock of Republican success for decades.
Deep red Trump-voting counties in deep red states have the highest poverty, lowest standards of living, and most reliance on social security in the nation. If this were a logical world, you might expect these people to support candidates with social policies designed to benefit them. You might have noticed we don’t live in a logical world, so these people are like turkeys turning out in droves to enthusiastically vote for Thanksgiving.
Enter the great state of Mississippi, which overwhelmingly voted for Donald Trump in 2024 (60.9% to Kamala Harris’ 38%. A year and a half into Trump’s second term, many Mississippians are likely suffering a bad case of buyer’s remorse as gas prices rise and the economy stalls.
But it’s Donald Trump’s Big, Beautiful Bill that’s really going to make their lives a misery. Healthcare in Mississippi was already at breaking point before Trump, with the state struggling to care for a high rate of people with no medical insurance. Furthermore, Mississippi has one of the highest reliance on Medicaid in the nation, covering around 50% of children and 57% of births, with hundreds of thousands of enrollees.
Trump’s so-called “big, beautiful bill” slashes over $1 trillion from Medicaid. In states like Tennessee, Mississippi, and Arkansas, that funding keeps rural hospitals alive.
— Protect Our Care (@ProtectOurCare) August 28, 2025
Without it, hospitals close, ERs shut down, and families lose lifesaving care. #MedicaidMatters pic.twitter.com/pW032KCxzB
Trump’s cuts are likely to push struggling rural hospitals over the edge, potentially leaving tens of thousands of people without adequate access to emergency treatment or longer-term care. For example, if you develop cancer and you live in one of the affected communities, the misery of chemotherapy may be compounded by endless hours of travel to receive it.
Mississippi lawmakers are having sleepless nights, with Rep. Sam Creekmore (R) confirming that figuring out how to minimize the damage will occupy “a lot of our time going forward out of session and next year.”
It’s going to get bad
Rural hospitals in states like Mississippi are being squeezed by a Medicare wage index that undercuts reimbursement, making it harder to keep doctors, specialists, and critical services in our communities. Today, I asked Secretary Kennedy if we can count on the administration to… pic.twitter.com/r6emtpTzGq
— U.S. Senator Cindy Hyde-Smith (@SenHydeSmith) April 21, 2026
DC has thrown Mississippi a liferaft with the federal Rural Health Transformation Program, intended to support rural hospitals with a $206 million fund, but Joan Alker, executive director of Georgetown University’s Center for Children and Families says this simply isn’t enough to save rural hospitals from crisis:
“It’s not enough money, and it’s not designed to replace it…This is not going to address the crisis that many rural hospitals are facing.”
Sen. Hob Bryan (D), chair of the Senate Public Health Committee, was blunt about his assessment: “I’m absolutely terrified about what is going to happen to people in rural areas”.
The depressing conclusion is that, in voting for Donald Trump, many Mississippians unknowingly signed their own death warrants. There may yet be some hope in the future under a new administration, or if DC decides the situation is so grave that further federal intervention must take place. But in between then and now, a lot of poor rural people are going to die.
Meanwhile, in DC, a lot of already-rich people are enjoying watching their personal wealth balloon. Ever wonder if there might be a connection between your misery and their joy?
Published: Apr 22, 2026 07:32 am