On a sweltering August afternoon in Peachtree City, Georgia, Vice President JD Vance took the stage at the ALTA Refrigeration facility, eager to sell what he called an “American tax cut” to a crowd of several hundred. The law in question, President Donald Trump’s recently signed One Big Beautiful Bill Act (OBBBA), has quickly become the centerpiece of the administration’s economic message as the 2026 midterm elections approach. But as Vance spoke for over half an hour, the rift between Republican promises and Democratic warnings over the bill’s impact became impossible to ignore.
Standing before a massive American flag and banners that read “Jobs! Jobs! Jobs!”, Vance painted the OBBBA as a lifeline for working-class Americans. “If you’re working hard every single day right here in the United States, or if you’re building a business right here in the United States, you ought to have a tax code that rewards you instead of punishes you,” he declared, according to the Associated Press. He claimed that the bill would boost take-home pay for working Americans by more than $10,000 over several years, thanks to new deductions on overtime and tips, and an expanded child tax credit.
But not everyone was buying the pitch. Less than two miles away, a group of protesters—many of them retirees and longtime residents—gathered to voice their fears that the bill’s deep cuts would devastate hospitals, food assistance, and the vulnerable. “All these cuts are going to hurt us. They’re taking money from poor people,” said Phyllis Williamson, a 77-year-old Fayetteville resident. “Stop hurting the middle class. Stop hurting seniors and children and poor people. Do something for somebody besides the rich.”
Vance’s visit came during a week of mounting scrutiny over the bill’s real-world effects. According to multiple news outlets and health policy groups, rural hospitals across the country have begun reporting dire consequences since the law’s passage in July. Evans Memorial Hospital in Claxton, Georgia, for example, now faces a $3.3 million budget shortfall, prompting its CEO to warn that the facility’s intensive care unit could be on the chopping block. The hospital’s predicament, as reported by the Associated Press, has become a rallying cry for those warning that the bill’s $1.2 trillion in cuts to Medicaid and food stamps will hit rural communities hardest.
Senator Jon Ossoff, the Georgia Democrat up for reelection in 2026, wasted no time in highlighting these concerns. Speaking at the Clayton County Chamber of Commerce in Jonesboro, Ossoff lambasted the law as “hugely unpopular,” arguing, “It is embarrassing for the vice president to be coming to Georgia to sell a policy that is already resulting in harm to hospitals in the state of Georgia, that’s projected to throw more than 100,000 people off of health care.” He cited a Congressional Budget Office (CBO) analysis showing that the top 10 percent of earners would gain an average of $13,600 per year over the next decade, while the poorest 10 percent would see their incomes drop by $1,200 annually.
Vance, for his part, dismissed the CBO report as “absolutely atrocious,” telling the crowd, “Sometimes they put out reports that are absolutely atrocious, and I think this is a good example of a very atrocious report.” He doubled down on the bill’s benefits for workers, arguing, “If you’re working hard and you’re working overtime, you’re going to get a big fat tax cut. If you’re working at a restaurant or some other business where you’re earning your wages primarily through tips, you’re going to get a big fat tax cut. And most importantly, the president’s economic policies are going to prevent your job from being shipped off to Asia or to Mexico. That is the very best thing for people at the bottom of the income ladder.”
Yet the vice president’s rhetoric did little to quell concerns over the law’s impact on health care. Health policy research group KFF estimated that the changes to Medicaid and the Affordable Care Act could cause around 17 million people to lose coverage. Democratic lawmakers contend that nearly 300 rural hospitals are at risk of shutting down, a claim that has sparked outrage among critics across the country. New York Governor Kathy Hochul, for instance, blasted Vance’s claims about rural hospitals, writing on X (formerly Twitter), “Donald Trump’s Big Ugly Bill puts 29 rural hospitals in New York on the chopping block.”
The law does include a $50 billion Rural Health Transformation Program, which Republicans argue will help offset provider losses. But for many hospital administrators, the math simply doesn’t add up. As one social media user posted, “At least he believes what he’s saying. Doesn’t help all of the rural clinics that had to close because they lost funding. Or the major hospitals that had to cut back on services because their funding was pulled as well.”
Vance has repeatedly sought to link the bill’s cuts to immigration, asserting that Medicaid reductions would only impact “illegal aliens.” In his speech, he insisted, “It’s not about kicking people off of health care. It’s about kicking illegal aliens the hell out of this country, so that we can preserve health care for American families.” He added that benefits like Medicare and Medicaid should be reserved for citizens, not those “who have no legal right to be in the country.”
Republican hopefuls for the U.S. Senate—including former football coach Derek Dooley, Congressman Mike Collins, and Congressman Buddy Carter—joined Vance in denouncing Ossoff and praising the OBBBA. Dooley accused Ossoff of supporting policies that led to high inflation and “wide open” borders, while Collins painted the senator as a “trust fund kid” out of touch with Georgia values. Carter, meanwhile, called for stricter work requirements for Medicaid and blamed immigrants for endangering the program.
Despite the partisan fireworks, the real-world stakes remain high for Georgia’s rural communities. Many hospitals rely heavily on Medicaid funding, serving a disproportionate share of low-income patients. The new law’s changes, including new work requirements and limitations on how states can fund their programs, have left administrators scrambling to keep their doors open. The Rural Health Transformation Program may offer some relief, but whether it will be enough is an open question.
As the 2026 midterms draw closer, both parties are betting that voters will remember these debates at the ballot box. For Republicans, the OBBBA is a symbol of their commitment to “working families” and a tax code that rewards hard work. For Democrats, it is a cautionary tale of what happens when budget cuts hit the most vulnerable. In the words of Loretta Keith, a 65-year-old protester and retired teacher, “I’m worried about it going further than it’s gone, and we can’t bring it back, that people are just going to die, just like Nazi Germany, and it breaks my heart.”
With emotions running high and the facts in hot dispute, the fate of Georgia’s rural hospitals—and the families who depend on them—hangs in the balance as the nation looks ahead to another pivotal election year.
