Exclusive: New Poll Finds Rural Voters Concerned About Health Care Cuts

In a new poll, likely voters in Republican-leaning states are concerned about the future of healthcare, the results of Trump’s cuts to Medicaid, and what the next Congress will do. The poll, seen first by RealClearPolitics, notes that voters in Kentucky, Mississippi, Louisiana, Alabama, and Missouri want Congress to ensure people promised protection keep their coverage even more than they want further health care reforms. Notably, despite the Trump administration’s push to reform the system by adding work requirements and limiting eligibility, respondents said they were more concerned about Medicaid disruptions and loss of resources to rural hospitals.

With a sample size of 2,000 respondents, the poll represents one of the few comprehensive looks at likely voters in rural areas, a population that is typically hard to capture in the data. Between 64% and 72% of rural likely voters are concerned that Medicaid disruptions will affect their communities, including up to 58% of Republican respondents, the survey found. The distrust of government officials and concern over tax changes in the One Big Beautiful Bill could mean a referendum on GOP-led health care changes in Tuesday’s elections.

Signed into law on July 4, 2025, the One Big Beautiful Bill codified several funding cuts and tax cuts important to the Trump administration. It was projected to reduce federal Medicaid spending by $911 billion over 10 years. It also implemented requirements that enrollees prove they work 80 hours per month, are in some sort of education program, or participate in a qualifying community engagement to crack down on fraudsters. The new rule kicked roughly 5.3 million enrollees off Medicaid plans. But to mitigate cuts in rural areas, the law also built the Rural Health Transformation Program to give $50 billion in state grants through 2030. The Congressional Budget Office estimated the changes will kick up to 11 million Americans off their health coverage plans by 2034.

Over the past year, Democrats have argued that the One Big Beautiful Bill hurt rural communities rather than delivering the benefits Trump promised. Trump also rebranded the legislation as the Working Families Tax Cuts to promote his agenda during the midterm cycle. But this poll shows his message might be falling flat among rural voters.

A majority of respondents in all five states said they were concerned about Medicaid disruptions. In all but Mississippi, most respondents also said that Medicaid mostly works rather than spiraling out of control. That perception is a problem for the administration. Trump claimed that illegal immigrants and low-income Americans were taking advantage of the system and wasting taxpayer dollars. This was the incentive to cut programs under the Department of Government Efficiency and to then codify some of those changes through the OBBB.

Between 61% and 68% of respondents said their health care costs rise if local hospitals close or cut back. More specifically, respondents highlighted their concerns that veterans and seniors will lose care, that patients will have longer ambulance and emergency room wait times, that cancer and dialysis patients will have to travel farther, and that labor and delivery units will close.

A recent report from the Paragon Institute tracked the launch of 500 new health care facilities in rural and low-income areas since the OBBB’s passage, arguing that fears on cuts to rural hospitals have been unfounded. Nevertheless, some of the bill’s largest reforms have not yet taken effect. And the new poll shows that voters are still feeling anxious about their health care access.

Perhaps most unsurprising, voters trust their doctors and nurses far more than any government officials to inform them about hospital funding. Between 36% and 48% said they would trust Trump administration officials compared to a range of 79% as high as 90% who said they trust a veterans organization and local doctors.

When asked what they want Congress to do on Medicaid, most likely voters said they want their elected representatives to make sure that everyone who was promised protection can keep their coverage. The margins were slightly higher among 2024 Trump voters.

Views on Medicaid changes differed by region. The administration’s argument that it had to cut waste, fraud, and abuse was more popular in the rural Midwest than it was in the rural south, where more respondents said they felt that the administration broke Trump’s promise to not cut Medicaid. Even after hearing arguments on fraud and abuse, between 40% and 49% of respondents still supported limiting how far the administration can go to change Medicaid.