Echoes of Appalachia

If you scroll through social media or watch the news, you may see members of Congress and well-funded interest groups urging families across West Virginia and the wider Appalachian region to believe that the so-called Big Beautiful Bill, known as HR 1, will somehow strengthen our communities. Folks throughout these mountains understand a raw deal when we encounter one. This legislation strips health care access, weakens food assistance, and raises expenses for nearly every household while offering enormous tax breaks for wealthy individuals. With many Appalachian states facing some of the steepest program reductions, our towns and rural areas stand to absorb the earliest and harshest impacts.

Supporters of HR 1 promote claims of significant tax reductions for families across the region. Those claims collapse under scrutiny. Many of the tax changes they highlight already exist under current policy, and the averages they promote are heavily influenced by massive gains flowing to millionaires.

In West Virginia and across Appalachia, the lowest earning households are projected to face higher taxes compared with current levels. The median household would receive a cut far smaller than the average figure promoted by backers of the bill. Meanwhile, the highest earning households take home most of the advantage, with eighty percent flowing to the wealthiest ten percent. Once tariffs and other provisions are included, independent analysts forecast that by 2027 nearly every household in the country will face financial harm.

The most severe consequences reach far beyond taxes. To fund changes that reward the wealthy, Congress approved the deepest reductions to Medicaid and SNAP in our history. For West Virginia, this means more than fifty thousand residents losing health coverage and thirty-three thousand facing the loss of food assistance. Similar hardships threaten families in Kentucky, Tennessee, eastern Ohio, southwestern Virginia, and other Appalachian communities where wages run low and access to care already involves long drives and understaffed clinics. Seniors, veterans, parents, and individuals who worked for decades before encountering hardship all face disruptions to essential support.

These cuts spread economic strain throughout the region. Reduced federal support for health care and nutrition programs is expected to eliminate thousands of jobs as hospitals, clinics, grocery stores, pharmacies, and related employers absorb the financial hit. Experts foresee declines in wages and GDP, accompanied by a dramatic rise in the national debt.

Hospitals serving large Medicaid populations will experience fewer reimbursements and rising unpaid bills. This combination threatens layoffs, shrinking service availability, higher prices for private insurance, and even facility closures. A medical group in Virginia recently announced the shutdown of three clinics due to pressures created by the One Big Beautiful Bill and the realities it imposes on health care delivery. Similar closures could ripple across Appalachia, where many communities depend on only one hospital or one urgent care center.

Although members of Congress claim that communities have years to adjust, health care providers across the region are already facing difficult decisions, and several provisions begin immediately. The U.S. Department of Agriculture has instructed states to move forward with new SNAP restrictions. As a result, parents, veterans, and older individuals up to age sixty-four across West Virginia and neighboring Appalachian states will lose vital food assistance. Rising hunger will drive more families to food pantries that already struggle to meet demand with grocery prices climbing higher each month.

In January, state lawmakers across Appalachia will need to find resources within already-tight budgets to absorb federal Medicaid and SNAP expenses shifted onto the states. Combined with new tariffs included in the bill, everyday costs will rise even further, from food to household supplies, while paychecks lose purchasing power. Working families across the region will feel that pressure with particular intensity.

HR 1 arrives with promises of prosperity, although the reality for Appalachia looks far different. The legislation raises expenses, strips essential support, and channels its greatest rewards toward those with the highest incomes. Communities across West Virginia and throughout Appalachia deserve policies that strengthen families and foster opportunity rather than deepening hardship across our hills and valleys.

-Tim Carmichael