一些生活在农村地区的特朗普支持者表示，他们担心唐纳德·特朗普总统的税收和政策的影响签名周五成为法律。该法案对个人和社区的潜在医疗保健影响是一些人最关心的问题，而其他人则预计会对商业产生积极影响，但对该法案的价格保持警惕。

　　美国广播公司新闻采访了这些人，他们是在参议院于7月1日通过该法案后、众议院于两天后通过之前接受采访的。

　　该法案规定了更严格的医疗补助资格要求，这可能会影响农村医院的财务状况，农村医院往往比城市医院更依赖医疗补助资金，而且往往已经在微薄的利润上运营。

　　美国医院协会呼叫这对农村医院和患者的潜在影响是“毁灭性的”在法案通过的准备阶段，民主党参议员与北卡罗来纳大学教堂山分校的研究人员一起编制了一份338所农村医院名单这可能面临“财务困境”、“服务减少”或关闭的风险。

　　一些共和党参议员，包括参议员比尔卡西迪。医生，参议员苏珊·科林斯，R-缅因州表达关系该法案影响了他们州的医疗保健提供者。

　　为了应对这些担忧，参议院共和党人在法案中加入了一项措施，在五年内拨出500亿美元支持这些农村医院，但倡导者和专家表示，这可能不足以防止医院关闭和护理损失。国家农村健康协会在一份报告中说声明该基金将“不足以”抵消其他条款的影响。

　　詹姆斯是一名62岁的男子，住在北卡罗来纳州的一个半农村地区，他正在接受医疗补助，并获得补充营养援助计划(SNAP)的福利。他说，该法案将为他每月削减约300美元的福利。

　　“很难支付房租和其他一切费用，”他说。他补充说，他没有家人可以帮助支持他，因为他的哥哥已经去世，他的母亲在一家养老院。

　　作为一名独立人士，詹姆斯说他没有在2024年投票，但比起民主党候选人卡玛拉·哈里斯，他更喜欢川普作为候选人。

　　“我认为特朗普是两害相权取其轻，”他说。“但我错了……如果你想让穷人更穷，他做得很好。”

　　住在密西西比州哈蒂斯堡的保险代理人布莱恩·谢弗(Bryan Shaver)在2024年投票支持特朗普。

　　62岁的Shaver说，他并不担心法案中的医疗补助条款会影响到他的客户。“因为他们年纪大了，挣的钱很少，”他相信他们会符合新的标准。

　　然而，Shaver说，他“绝对担心”医疗补助削减会影响密西西比州的农村医院，其中一些他过去曾与之合作过。

　　“对他们来说，照顾他们需要照顾的人是极其困难的……他们在密西西比州很难生存，”谢弗说。

　　他说，医院的财务困境有时会减少周围人获得医疗服务的机会。

　　“这里的许多医院负担不起(提供护理)产妇，”谢弗说。“例如，密西西比州贝茨维尔的一家医院。(病人)必须开车去孟菲斯接生，这有点荒谬。”

　　谢弗说，他将拭目以待，看看法案中的条款将如何影响选民。如果有负面影响，他说，他希望共和党议员将“纠正它”，否则“被踢出去。”

　　斯蒂芬·卡拉威也投票给了特朗普，他住在辛辛那提以东约70英里的一个农村地区。他说，他预计该法案将对他自己和他的社区产生积极影响。卡拉威被任命为国家的选举俄亥俄州州长迈克·德温(Mike Dewine)将于2023年上任，任期至2027年。

　　卡拉威说:“在我所在的俄亥俄州，有很多服务性工作和餐馆职位，我绝对认为不对小费或加班费征税对中产阶级和那些雇员来说是件好事。”他说，他个人将从该法案延长的一些减税措施中受益。

　　对卡拉威来说，收紧医疗补助的资格要求似乎是合理的，他并不担心该法案会让数百万人失去福利，并可能伤害像他住在附近的农村医院。

　　卡拉威的一个担忧是该法案对美国债务的影响。国会预算办公室估计这将在十年内增加3.4万亿美元的赤字。

　　“不管哪个政党掌权，我要告诉你们，联邦政府需要一次彻底改革，而且已经需要很长时间了。唯一能让我停下来的是CBO的一些预测，”卡拉威说。“但我认为，这些预测可能是正确的，也可能是不正确的。我将相信我的国家领导人会做正确的事情，并在财政上负责任。”

　　Some of those who supported Trump have concerns about what's in his megabill

　　Some Trump supporters living in rural areas say they have concerns about the impact of President Donald Trump’s tax and policy megabill, which hesignedinto law on Friday. The bill’s potential health care impacts, both personally and on their communities, were top of mind for some, while others anticipated a positive impact on business but were wary of the bill’s price tag.

　　ABC News spoke with these people after the Senate passed the bill on July 1 but before the House did two days later.

　　Provisions in the bill enacting stricter eligibility requirements for Medicaid could impact finances for rural hospitals, which tend to rely more on Medicaid funding than urban hospitals and often already operate on tight margins.

　　The American Hospital Associationcalledthe potential impact on rural hospitals and patients “devastating.” In the leadup to the bill’s passage, Democratic senators working with researchers from the University of North Carolina Chapel Hill compiled alist of 338 rural hospitalsthat could be at risk of “financial distress,” “service reductions” or closure.

　　Some Republican senators, including Sen. Bill Cassidy, R-La., a physician, and Sen. Susan Collins, R-Maine, hadexpressedconcernsabout the bill impacting health care providers in their states.

　　In response to these worries, Senate Republicans included a measure setting aside $50 billion over five years in the bill to support these rural hospitals, but advocates and experts say it may not be enough to prevent hospital shutdowns and loss of care. The National Rural Health Association said in astatementthat the fund would “fall short of” offsetting the impact of other provisions.

　　James, a 62-year-old man who lives in a semi-rural area in North Carolina, is on Medicaid and gets Supplemental Nutrition Assistance Program (SNAP) benefits. He said the bill would cut around $300 worth of those benefits for him per month.

　　“It’s going to be hard to pay the rent and everything else,” he said. He added that he didn’t have family that could help support him, now that his brother has died and his mother was in a nursing home.

　　Identifying as an independent, James said he did not vote in 2024 but had liked Trump as a candidate more than Democratic nominee Kamala Harris.

　　“I thought Trump was the lesser of two evils,” he said. “But I was wrong … If you want to make the poor people poorer, he’s doing real good.”

　　Insurance agent Bryan Shaver, who lives in Hattiesburg, Mississippi, voted for Trump in 2024.

　　Shaver, 62, said he was not worried about the Medicaid provisions in the bill affecting his clients. “Because they're elderly and they make very little money,” he was confident they would meet the new criteria.

　　However, Shaver said he was “absolutely worried” that the Medicaid cuts could affect rural hospitals in Mississippi, some of which he had worked with in the past.

　　“It was extremely difficult for them to take care of who they needed to take care of … it's very difficult for them to survive in Mississippi,” Shaver said.

　　He said hospitals’ financial struggles sometimes reduced access to care for the people living around them.

　　“A lot of the hospitals here can't afford [to provide care for] maternity,” Shaver said. “For example, a hospital up in Batesville, Mississippi. [Patients] have to drive to Memphis to deliver a baby, and that's kind of ridiculous.”

　　Shaver said he would wait to see how the provisions in the bill would affect voters. If there was a negative impact, he said he hoped Republican lawmakers would “correct it” or otherwise “get booted out.”

　　Stephen Caraway, who also voted for Trump, lives in a rural area around 70 miles east of Cincinnati. He said he anticipated a positive effect for himself and his community from the bill. Caraway was appointed to the state’sElectionsCommission by Ohio Governor Mike Dewine in 2023 and will serve until 2027.

　　“There are service jobs, a lot of restaurant positions in my part of Ohio, and I absolutely think that no tax on tips or overtime would be great for the middle class and for those employees,” Caraway said. He said he would personally benefit from some of the tax cuts the bill extended.

　　To Caraway, the tightened eligibility requirements for Medicaid seemed reasonable, and he did not buy into worries that the bill would take millions of people off the benefits and potentially hurt rural hospitals like the one he lives near.

　　Caraway’s one concern is the effect the bill would have on U.S. debt. The Congressional Budget Officeestimatesthat it would add $3.4 trillion to the deficit over a decade.

　　“Regardless of what party was in control, I would tell you that the federal government needs an overhaul, and has needed it for a long time. The only thing that would give me pause is some of those CBO projections,” Caraway said. “But I believe that those projections can just as easily be incorrect as they can be correct. And I'm going to trust my national leaders to do what is right and be fiscally responsible.”