By Eva McKend, CNN

Churchville, Virginia (CNN) — As the final hues of autumn linger in the Blue Ridge Mountains, the 200-person community of Churchville, Virginia, is grappling with the loss of its health clinic.

Gone are the days of seniors walking down the road from their house to see the town doctor.

Augusta Medical Group cited the health care provisions in President Donald Trump’s signature legislation, the One Big Beautiful Bill Act, for closing the rural clinics in Churchville and two other locations.

“I’ve called around trying to find a replacement, a new doctor, and for just a well-being appointment, the soonest is the end of January,” said Teresa Leach, 56, in an interview while sipping her coffee at the MTN. Mystic shop just a few feet from the shuttered clinic. Leach, who has asthma, said she voted for Trump last year.

Democrats are hoping to make health care a defining issue nationally in next year’s midterms. But the environment in Churchville illustrates the challenges the party faces, particularly in rural communities.

Trump carried Augusta County, which includes Churchville, by nearly 50 points in 2024. Jena Crisler, a physician, ran to represent the area in the Virginia House of Delegates and lost this month to the Republican incumbent by more than 40 points even in a Democratic statewide sweep.

A woman sitting in the same coffee shop whispered under her breath that she supported former Vice President Kamala Harris in 2024. It takes her over an hour to visit her doctors in Charlottesville. Rural health care is always precarious, she says, and the clinic closure was especially a blow for her husband.

But she said she wouldn’t put up a sign for a Democrat “because of the environment,” and she declined to be named by CNN.

Across the street from the coffee shop, a sign in the window of a storefront reads, “Thank you, Trump, Save America Again.”

How the Trump megabill affected rural health care

Rural health providers that rely on Medicaid funding were already under strain before the bill cut federal health spending by hundreds of billions of dollars over the next decade, primarily by instituting work requirements and more eligibility checks.

Lynlee Thorne, political director of Rural Ground Game, a group focused on driving up Democratic participation in rural areas, says Democrats will continue highlighting the significance of accessible health care through town hall-style events and canvassing, trying to win back credibility and trust in rural America.

“I think people have an interest in having real conversations about what’s going on with their lives, and there’s really nothing that can replace that person to person at your doorstep conversation,” Thorne said.

Crisler knew she faced long odds when she took on incumbent Delegate Chris Runion in the state’s 35th district. She suggests her race was less about the outcome and more about the need for Democrats to show up everywhere instead of simply surrendering communities where they’re outnumbered.

“I think they are very concerned, and they’re going to be even more when it starts hitting them personally,” said Crisler of the clinic closures.

A spokesperson for Runion said he was not available for comment.

CNN has reached out to US Rep. Ben Cline, a Republican who represents the area in Washington and voted for the Trump policy bill. His office did not respond.

Pediatrician Mark Downey defeated incumbent Republican Chad Green in the state’s 69th district, which includes Newport News, York, James City and Gloucester counties. In an interview with CNN, he said it’s important Democrats continue to run on health care even if the message does not immediately resonate with voters.

“It may not happen overnight. People’s minds don’t change right away, but when they start seeing loss of access, loss of services, eventually there’s going to be a situation where it’s not going to be as convenient for them or more of a hardship for them,” said Downey, who had made two previous unsuccessful tries for the state legislature.

Some people are speaking out

Irene Holmes, 59, moved to Churchville three years ago. When her son died, she and her husband wanted a change of scenery from New York. Beset with a host of medical challenges from liver issues to high blood pressure, she relied on and valued the town clinic.

“I’m a mixed bag of tricks, a lot of medical issues,” she said.

On politics, she tends to “keep her mouth shut” to avoid getting into it with her neighbors. But when asked if Trump was to blame for the clinic closure, Holmes said, “Absolutely.”

“What he’s done is destroying rural areas,” said Holmes.

Dale White, a Churchville resident and church administrator, says the concerns about the clinic are overblown.

“These are old-time rural farming folks, and they’ve been going to get medical care in Staunton and Fishersville, Waynesboro and Charlottesville since they can remember,” said White.

Back at the MTN. Mystic coffeehouse, shop owner Dane Buse suggests now is the time for rural communities to get creative.

“To lose the clinic is the same as losing a grocery store or a local provider,” Buse said.

He suggested the community could band together to find a doctor to make house calls.

“Maybe that would fit the bill for us,” Buse said.

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