When Republicans passed their big domestic policy bill just over a week ago, they kept making the same argument about sweeping changes to Medicaid: that the measures, including new work requirements, would encourage able-bodied adults to earn their health care, ultimately creating a fairer system for everyone. Critics said the opposite: they have predicted that millions of working people who need health care will lose it.

The truth will emerge in rural and often Republican-voting areas where cuts to Medicaid funding will be felt most deeply. Natalie Kitroeff spoke to a family doctor in one of those places, western North Carolina, about what she thinks will happen to her patients.

Guest: Shannon Dowler, a family physician and health advocate in western North Carolina.

Background reading: 

• In North Carolina, President Trump’s domestic policy law jeopardizes plans to reopen one rural county’s hospital — and health coverage for hundreds of thousands of state residents.
• The nonpartisan Congressional Budget Office predicted that the Senate’s version of Trump’s bill would mean that 11.8 million more Americans would become uninsured by 2034.

For more information on today’s episode, visit nytimes.com/thedaily. Transcripts of each episode will be made available by the next workday. 

Photo: Kaoly Gutierrez for The New York Times

Unlock full access to New York Times podcasts and explore everything from politics to pop culture. Subscribe today at nytimes.com/podcasts or on Apple Podcasts and Spotify.