[Editor’s note: John Boyle has the day off.]

We can all agree that Tropical Storm (née Hurricane) Helene was the worst natural disaster to hit our region in recent memory, taking more than 100 lives and leaving behind an estimated $59.6 billion in damage statewide.

Yet in terms of financial costs and lives potentially lost and disrupted, an equal or more devastating blow to Asheville and western North Carolina could be coming — this time, a man-made disaster, the result of legislation, executive orders, and decisions made by politicians after Helene.

The first line in the About Us section of our website says: “Asheville Watchdog is a free, local, not-for-profit, nonpartisan news organization.” I’d add “fact-based.” 

Some readers legitimately question whether we live up to the “nonpartisan” description. But facts are black and white, not red or blue. And the facts — compiled and reported by nonpartisan experts — are that newly enacted government policies including the widely unpopular One Big Beautiful Bill will have costly and deadly consequences for all of us, Republicans, Democrats, and independents alike. 

The parallels in the costs and effects of the two disasters — one natural and fast-moving, the other one unnatural and deliberately designed to unfold over a decade — are deeply unsettling. 

Our congressman, Republican Rep. Chuck Edwards, focuses instead on the positive benefits President Trump is delivering to western North Carolina since he took office six months ago today. These include, Edwards said, “common-sense reforms,” the elimination of fraud and waste, the economic stimulus of lower income taxes, increased safety because of deportations of criminal immigrants, and eradication of “woke” ideologies in businesses, schools, and government.  

But the projected numbers are worthy of consideration regardless of your political leanings, and so far, none of the politicians responsible for implementing these policies has stepped up to refute the facts or the ominous projections made by nonpartisan economists, physicians, and government agencies.

Helene left behind tens of billions of dollars in damage in our region.

North Carolina will be hit with “tens of billions of dollars in lost funding” because of the legislation, Sen. Thom Tillis, a Republican, said. But that’s just the start. In addition, the Department of Government Efficiency (DOGE) gutted federal programs that provided millions of dollars in local support. Congress voted last week to rescind billions of dollars it had already approved and promised to the states, including millions that our local government and nonprofit agencies were counting on as our community recovers from Helene.

Helene was deadly.

Cutting hundreds of billions in healthcare funding will be lethal too, medical experts say.

An analysis from the University of Pennsylvania and Yale University projected that the legislation’s changes to Medicaid and the Affordable Care Act will result in at least 42,500 preventable deaths nationwide each year. Their analysis includes 11,300 deaths resulting from people losing Medicaid or Affordable Care Act insurance, 18,200 deaths from low-income Medicare patients losing prescription drug benefits, and 13,000 deaths from rescinding a Biden-era rule that required a higher minimum staffing level in nursing homes. 

Another study, from researchers at the medical schools at the University of North Carolina and the University of California San Francisco, projected the One Big Beautiful Bill signed into law on July 4 will result in 94,802 preventable hospitalizations, 1.6 million people delaying care due to cost, and 1.9 million cases of patients failing to take medications as prescribed by their healthcare providers.  

“The Democrats have come up with a false narrative. … It’s death, death, everyone’s going to die,” Trump said in a cabinet meeting July 8. As he had before, Trump said that the bill was “just the opposite. Everyone’s going to live.”

Not so, said Rachel Werner, a physician and co-author of the Penn-Yale analysis. In an interview with the multimedia healthcare site Tradeoffs, she said, “Getting someone insurance allows them to get screened for diseases like cancer. It’s a major source of providing people with treatment for the opioid epidemic. It allows people to get medications to manage their chronic conditions. And so if you suddenly pull back all those resources that have been allowing people to get the care they need, the evidence is very clear now that we will lose lives.”

A White House spokesman, asked by FactCheck.org to comment on the numbers, dismissed them as “pointless fact checks that rely on mindless hairsplitting.”  

In December 2023 North Carolina’s General Assembly expanded Medicaid — the joint federal and state program that helps cover medical costs for some people with limited income and resources, including eligible low-income adults, children, pregnant women, elderly adults and people with disabilities — to include more needy families. 

But state lawmakers also included a “trigger” clause that discontinues Medicaid expansion if the state is forced to pay a higher share of the costs. Unless the General Assembly rescinds the trigger, as many as 670,000 people statewide are at risk of losing Medicaid Expansion coverage in coming years if North Carolina doesn’t somehow make up for the federal cuts.

Of those, an estimated 45,000 to 50,000 live in Rep. Edwards’s NC-11 district.

In Buncombe County, 16,161 adults are enrolled in Medicaid expansion — 9.8 percent of the adult population age 19-64, according to the North Carolina Department of Health and Human Services.

“It’s estimated that for every 1,000 people on Medicaid annually, something between 1 and 4 lives a year are saved,” the Penn-Yale researchers wrote.

Do the math, and compare it to Helene’s death toll.

Helene overwhelmed hospitals and healthcare providers in our region, where residents are older, poorer, and sicker than in many other parts of America.

People without health insurance often skip seeing a doctor for preventative services and use hospital emergency rooms for their primary healthcare. Our hospitals in western North Carolina are already struggling with staffing and low government reimbursement rates.  

The left-leaning Center for American Progress projects that the Medicaid cuts, along with the House refusing to extend the enhanced premium tax credits of the Affordable Care Act, could drive up uncompensated care costs in North Carolina by $1.48 billion by 2034, threatening the financial viability of the state’s rural hospitals, 12 percent of which are already at immediate risk of closure. 

Angel Medical Center in Franklin and Blue Ridge Regional Hospital in Spruce Pine are heavily dependent on Medicaid reimbursements and will be at risk for closing altogether as a result of the new budget bill, according to an analysis by the Cecil G. Sheps Center at the University of North Carolina at Chapel Hill.

The closure of North Carolina’s rural hospitals would make it harder for all North Carolinians to access care regardless of their health coverage.

Losing significant federal Medicaid funds could also force the state to reduce or eliminate optional Medicaid benefits for people with disabilities, including home- and community-based care that enables them to live independently.

According to recent data from North Carolina’s Medicaid program and reporting from NC Health News and WRAL, over 60 percent of nursing home stays in the state are paid for by Medicaid. 

Meanwhile, health insurers are proposing double-digit price hikes for plans sold through Affordable Care Act marketplaces, as extra federal subsidies for premiums expire at the end of the year and as Trump’s tariffs threaten higher pharmaceutical prices. Trump is threatening to impose tariffs of up to 200 percent on imported pharmaceuticals, The Hill reported July 8. 

The nonpartisan health policy organization KFF analyzed insurer filings and projects that the average person buying a marketplace plan would pay 75 percent more for their monthly premium if Congress doesn’t extend the subsidies. KFF reported that the median monthly premium increase would be 15 percent.

Helene sharply increased demands for government and nonprofit services.

Hundreds of millions in lost federal funding will shift an almost insurmountable financial burden onto county and city governments already wondering how they’ll pay off millions in storm-related costs.

The choices are stark: cut services, or raise property taxes, or both.

Cuts to the Supplemental Nutrition Assistance Program (SNAP, formerly known as Food Stamps) total approximately $186 billion to $230 billion nationwide over the next decade. 

As The Watchdog reported earlier, federal changes will force our state to pay an extra $420 million to fund the full benefits of SNAP or end the program. More than 1.4 million North Carolinians, including 600,000 children, rely on SNAP for basic food and nutrition.

The cuts also involve stricter work requirements for “able-bodied adults without dependents,” while shifting the cost for reporting/accountability measures — not just SNAP, but Medicaid as well — to the state. 

Nearly 30,000 Buncombe County residents were enrolled in SNAP as of April 2025. In western North Carolina, an estimated 15 percent of households participate in the SNAP program, well above the national average of 12 percent, according to the U.S. Department of Agriculture’s Economic Research Service. Children and seniors are particularly vulnerable to the SNAP cuts.

Cutbacks in federal food assistance, along with rocketing grocery store prices, will increase the demand at nonprofits like Asheville-based MANNA Food Bank, which already distributes free food to about 150,000 needy people in western North Carolina every month.

Also, grocery stores face losing millions in revenue from SNAP shoppers. Some small, rural stores that depend on SNAP will be at risk of closing, adding to food insecurity in surrounding areas.

Helene caused job losses

The Asheville metropolitan area lost 8,200 jobs between September and October, about 4 percent of all regional jobs, according to the North Carolina Department of Commerce. Buncombe County’s unemployment rate soared to 10.4 percent in October, from 2.5 percent before the storm. 

By May 2025, the most recent tally available, the unemployment rate in Buncombe was 4.5 percent. Because the employment recovery from Helene is still ongoing, it’s difficult to definitively attribute recent job losses solely to the Department of Government Efficiency or cancellation of federal grant programs. 

However, nationally, more than 290,000 layoffs in the first four months of 2025 were attributed directly or indirectly to DOGE efforts to slash government funding and reduce the size of the federal workforce, according to a new report from outplacement firm Challenger, Gray and Christmas. 

Adding to the uncertainty, courts have ordered the government to rehire many of the workers fired by DOGE, or as a result of already-appropriated federal funds being rescinded. 

Many local companies say their business decisions are complicated because of uncertainty over Trump’s tariff threats and retreats. The Federal Reserve Bank in Richmond, whose region includes North Carolina, reported that 72 percent of regional firms have modified operations, including pricing, hiring plans, capital expenditures, and sourcing because of tariff costs and uncertainty. 

Ripple effects of the tariff policies have already impacted local businesses, including breweries, farms, restaurants, tourism, and local service providers. Prices are rising across sectors, including lumber, chemicals, machinery, auto parts, foodstuffs, and beer cans.

As Asheville and western North Carolina recover from Helene, jobs in hospitality, restaurant, healthcare, and other service occupations; construction and maintenance occupations; and transportation, and material moving occupations are all important. According to the federal Bureau of Labor Statistics, most of those jobs in 2024 were held by workers who were not born in the United States — including undocumented immigrants.

Census data show that more than 50,000 people who identify as Hispanic or Latino live in Buncombe, Henderson, Haywood, Transylvania, and five other westernmost counties in North Carolina, and as many as half are undocumented (“illegals,” in MAGA parlance), according to a study from the Charlotte-based Camino Research Institute. 

The Trump administration has set internal targets of deporting 1 million immigrants per year. If successful, a significant percent of the local workforce could be lost.

Helene caused havoc for local schools.

Although on Friday it released $1.4 billion in already authorized funding for after-school programs, the federal government is still withholding nearly $6 billion in education funding. This includes some $2 million in paused funding for Buncombe County schools. Affected programs include teacher professional development, before-school initiatives, academic enrichment, English language learner support, and migrant education.

Unless replaced by local funding, those services will be lost. (North Carolina is among 23 states suing the Department of Education, the Office of Management and Budget, and President Trump to release the funds.) 

In response to revenue loss resulting from Helene, Buncombe County in January slashed $4.7 million from the budget for Asheville City Schools and Buncombe County Schools. 

Asheville schools already have one of the largest achievement gaps in the nation between white and minority students. Following the double whammy of the COVID-19 pandemic and Helene, the cutbacks in federal aid for public schools could worsen an already struggling system and harm our kids.

Helene highlighted the need for better climate and weather data, and effective, long-term solutions for increasingly volatile weather conditions.

As part of a purge of federal workers, nearly 20 employees at the Asheville-based National Centers for Environmental Information resigned or were laid off. The Asheville center manages one of the world’s largest archives of climate data collected by scientists and researchers, and its work is crucial for accurate weather forecasting, natural disaster preparation, and emergency response. 

As a result of cuts at the National Oceanic and Atmospheric Administration and the National Weather Service, and plans to gut the Office of Oceanic and Atmospheric Research, western North Carolina — and the rest of the nation — is more vulnerable and less prepared for future weather calamities like Helene.

There are plenty of other issues arising from the past six months as Donald Trump tries to reshape America on the eve of its 250th anniversary. Science. Religion. Human rights and dignity. Diversity and inclusion. Constitutional rights and the law. Democracy. The list goes on. All can (and will) be viewed through a partisan lens. 

But when we see facts and data and other warning signs of an impending financial and healthcare disaster, let’s put partisanship aside. 

Recognizing the unpopularity of the legislation, Republicans delayed implementing the Medicaid budget cuts until after the midterm elections in 2026. Cynical? Obviously. 

But there are 470 days until the midterms. That gives us time to demand that anyone wishing to represent us in the General Assembly or Congress should be as determined to protect us from disastrous legislative harm as from natural disasters.

One final call-out:

The value of public media was affirmed when thousands of people in western North Carolina, cut off from newspapers, television, the internet, and other sources of reliable information, turned to Blue Ridge Public Radio.

The Watchdog’s friends at BPR won national and state journalism awards for their Helene coverage. We applaud them. Their coverage was a lifeline in the days and weeks following the storm, especially for listeners in rural areas.

Last week, in a partisan vote, Congress voted to defund the Corporation for Public Broadcasting, rescinding $1.1 billion in previously approved funds. 

For our local station, BPR, that means a loss of $330,000 annually. 

The cuts aren’t about saving taxpayer money. They’re about stifling criticism and silencing responsible journalism that holds power to account. 

[Watchdog summer intern Linus Schafer Goulthorpe contributed research for this column.]

Asheville Watchdog welcomes thoughtful reader comments on this story, which has been republished on our Facebook page. Please submit your comments there.

Asheville Watchdog is a nonprofit news team producing stories that matter to Asheville and Buncombe County. Peter H. Lewis is executive editor and a former New York Times senior writer, editor and columnist. Email plewis@avlwatchdog.org. The Watchdog’s local reporting is made possible by donations from the community. To show your support for this vital public service go to avlwatchdog.org/support-our-publication/.

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