After tasked with an editorial on the One Big Beautiful Bill Act that recently went into effect, I took a deeper look at the current state of healthcare in Newton County. As a resident of Union, Mississippi, with a local hospital minute away from my home, it never occurred to me the amount of despair, disdain, and discontent that members of our community feel with the current state of health care in Newton County. I placed a call for feedback on social media to people across Newton County asking them what their opinions are. Many say ambulance response times have worsened as staffing slipped and local EMS struggles to keep an advanced life support truck constantly in service. There were overwhelming complaints that the county no longer has a full-service hospital of its own, and residents describe long drives to Union, Meridian, Jackson, and other communities for emergency and inpatient care. Residents talked about waiting on ambulances, finding packed emergency rooms when they finally arrive out of town, and feeling that a basic layer of security has been stripped away.
Former member, Hannah Sanderson, of Newton County’s ambulance service says, “speaking out about those problems is not something she does lightly.” As she put it, “the service for years was a dependable and trusted resource, built on accountability, readiness, and a deep commitment to serving Newton County’s citizens,” and “seeing that standard falter is troubling for anyone who cares about public safety.” Former contributor Hannah Sanderson, who helped operate the service, said, “It makes me sad to see a system that once served Newton County well now struggling. We have a real heart for this community and want to see it have an ambulance service that is able to fulfill its contract and be there for Newton’s citizens.” The newspaper reached out to the current ambulance service provider, Ameripro, seeking comment. At the time of publication, officials had not responded.
These local concerns are unfolding alongside a sweeping federal law known as the One Big Beautiful Bill Act passed in 2025 with the backing of President Donald Trump. The law reduces Medicaid spending by nearly a trillion dollars and is set to end enhanced subsidies for health plans purchased on the Affordable Care Act marketplace. Rural hospitals across Mississippi, many already financially vulnerable, warned that lower Medicaid support and higher uncompensated care could speed up service cuts or closures, even as the law channels $50 billion nationwide over the next five years into a rural health care transformation fund intended to reshape care and delivery.
State lawmakers say they are still trying to understand exactly how that new money will flow, and what it will mean for communities like Newton. “Right now, the problem is that I don’t know what the governor’s plans are for the 200 million dollars the federal government has allocated for Mississippi,” Sen. Tyler McCaughn said “I’ve heard rumors that it will be used for some more advanced measures in an effort to get healthcare to more people, but those are only rumors. The legislature is working with the governor to make sure that we get the money into the right hands to get the access to health care for the people. Right now there is no exact plan. The governor’s office is spearheading this, and the healthcare committees in the legislature are going to see what route we can go to get the care to the people.”
The One Big Beautiful Bill Act does more than trim federal health spending. It rewrites the rules for who can get Medicaid, how states can finance their programs, and how easily people can keep Affordable Care Act coverage in ways that independent analysis says will increase the number of uninsured and strained safety net providers. On Medicaid, the law authorizes states to pursue work or activity requirements for many adult enrollees, mandates more frequent eligibility checks and tightens federal scrutiny of improper payments, including cases where paperwork is incomplete. It also tightens federal limits on provider taxes and related ‘hold-harmless’ finances agreements. It caps certain state-directed payments to hospitals at or near Medicare rates, which hits rural safety net hospitals that rely on enhanced payments to offset uncompensated care. Non-partisan estimates project that these provisions together cut federal Medicaid spending by nearly a trillion dollars over a decade and leave millions more people uninsured nationally.
The law also tightens access to Affordable Care Act marketplace coverage. It requires stricter pre-enrollment verification for premium tax credits in some automatic re-enrollments and ending access to premium tax credits for people enrolling through income-based special enrollment periods. Other provisions limit subsidies or tax credits for some immigrant groups and people who enroll outside standard qualifying life events, further shrinking the pool of insured patients for hospitals and clinics. That translates to fewer visits covered by insurance and more care delivered with no guarantee of payment.
For a place like Newton County where according to Mississippi Division of Medicaid nearly a quarter of residents and almost half of children relied on Medicaid in 2023, these changes carry concrete risk. If more adults lose Medicaid because of paperwork, work rules, or frequent redeterminations, and if marketplace coverage becomes harder to get or keep, more patients will show up uninsured to emergency rooms or delay care entirely until the conditions worsen. Rural hospitals and clinics already operating on thin margins can see reductions in Medicaid revenue and supplemental payments at the time their uncompensated care burden grows. Increasing the pressure to cut services or close. Camenesha Holliday, mother and Medicaid receptant, commented, she is "fearful with the changes to medicaid and what the implications are for future Medicaid availability for her and her child".
As hospitals and clinics continue to face financial pressure and workforce shortages trends accelerated since the COVID-19 pandemic, more care has shifted from traditional inpatient doctor visits towards telehealth and remote monitoring, especially in rural states such as Mississippi. Telehealth can make it easier for rural patients to reach specialists without driving hours, but researchers and clinicians also point to trade-offs: patients without reliable broadband services or devices can be left out, some conditions are harder to evaluate through a screen and virtual visits may widen gaps for people with low digital literacy or complex medical needs. For Newton County residents already navigating long distances, limited provider options, and a fragile ambulance system, the move towards remote care risks layering a new barrier on top of existing ones rather than fully replacing the role of a nearby emergency room or hospital bed.
Addressing these gaps in healthcare will not be quick or simple, but Newton County is not powerless. Residents, providers, and policymakers each control pieces of the solution. Local leaders can keep pressing the state to use federal health funds in ways that stabilize rural hospitals and EMS rather than concentrating on resources only in larger cities. Community members can continue sharing their experiences, supporting local clinics and nurse practitioners, and staying engaged when the hospital board's supervisors and legislators ask for public input. Health systems and elected officials can look seriously at options such as a rural emergency hospital model or a hospital-affiliated emergency department, stronger partnerships with regional hospitals and targeted investments in broadband so that telehealth becomes a supplement, not a substitute for in-person care.
Most of all, sustained attention matters. The voices that spoke up about long drives, slow ambulances, and crowded ERs have already helped define the problem. Keeping these stories in front of decision-makers, insisting on transparency about how money is spent, and advocating for practical fixes, better EMS staffing, smarter use of Medicaid dollars, and renewed investment in rural facilities can help ensure that Newton County needs are not an afterthought. The path forward will be complicated, but a community that understands what is at stake and refuses to be quiet about it has a better chance of rebuilding a system that is closer, more reliable, and worthy of the people it serves.
This coverage is supported by a grant from Press Forward Mississippi, part of a nationwide philanthropic effort to strengthen local news so communities stay informed, connected and engaged.
