But this bill goes far beyond taxes. Like any major federal initiative, it’s stirring debate across the aisle. Supporters applaud its bold scope, while critics warn of cuts in areas they believe should have been protected.

This week, let’s spotlight a small but powerful section of the bill—one that hits close to home: changes to Medicare and their impact on rural hospitals.

While the bill spans countless subjects, the Medicare reforms will be felt most immediately in rural communities, where access to care is already fragile. These hospitals depend heavily on federal reimbursements, and shifts to eligibility or coverage could trigger widespread consequences. Whether you’re a patient, healthcare worker, or hospital administrator, the ripple effects are likely to reach you.

So, what exactly is changing? Most notably, undocumented immigrants will no longer be eligible for Medicare. This marks a sharp break from previous policy, which allowed for non-emergency care under Medicare’s umbrella. Critics of the old system questioned how some American citizens could be denied coverage while undocumented immigrants received it automatically. The new policy is designed to close that perceived loophole.

To be clear, emergency lifesaving treatment will still be available to all—regardless of immigration status—but hospitals will need alternative funding, as Medicare will no longer foot the bill.

The reforms don’t stop there. Reports claim that up to 300,000 Virginians could lose Medicare access, but this figure is more nuanced than it appears. Roughly half of those affected are able-bodied adults without dependents who aren’t working, studying, or volunteering. Under the new law, maintaining benefits will require logging at least 80 hours per month in work, education, or community service. The intent is to promote self-sufficiency and ensure that limited resources go to those who truly need them.

Still, there’s good news on the funding front. Virginia is set to receive $500 million through the Rural Health Transformation Grant—an investment aimed at modernizing and stabilizing local healthcare systems. Though controversial, it’s a step toward sustaining rural hospitals. Importantly, some facilities have closed recently, but these closures began well before the Big Beautiful Bill and shouldn’t be pinned solely on it.

The truth is, rural America has faced mounting healthcare challenges for decades. The struggle didn’t begin overnight. Many trace it back to the economic shifts following NAFTA and the Clinton-era policies that hit industries like clean coal and manufacturing—eroding the job market and weakening entire communities. Without a solid economic foundation, education, healthcare, and infrastructure all suffer. Today’s rural healthcare crisis is rooted in long-term neglect as much as recent legislative change.

Rural hospitals are the cornerstone of rural economies, often one of the largest employers in the area. When a hospital closes, or any loss of their valuable services occurs, this has a cascading effect. It doesn’t just impact patients – it undermines job security, housing stability, and even local schools.

I am committed to continuing my work in finding solutions for my district, which struggles in what has become a rural desert in many areas of services.

My staff and I are always here to assist you with any issues or concerns. Please don't hesitate to reach out if we can be of service. You can reach us at 434.374.5129 or by email at [email protected]