McDowell County, North Carolina, has long worn its loyalty to Donald Trump like a badge of honor. In the 2024 election, locals voted for him by a landslide — 74% to 25%. But a year later, that same county is struggling to recover from the devastating impact of Hurricane Helene, and many residents are realizing that their unwavering support may have come at a painful cost.
As The News and Observer reported, “The county of about 45,000 in the mountains of western North Carolina is still recovering from the devastation of Hurricane Helene a year ago. Its difficulties have been made worse by a low level of federal relief funding and bungling by the Federal Emergency Management Agency under Trump and his Homeland Security Secretary, Kristi Noem.”
That federal response, or lack of it, has left many residents frustrated and disillusioned. Yet McDowell County remains deep red — a place where voting Republican is as common as Sunday church. And that’s the paradox. These same communities that depend heavily on federal aid often vote for politicians who promise to shrink it.
Amy Stevens, who helps residents sign up for coverage under the Affordable Care Act, has seen that contradiction up close. “Here in the western part of the state, which is a red area, I’ve actually enrolled people in the ACA who are so excited to have coverage,” she told The News and Observer. “But then they say, ‘You didn’t enroll me in that Obamacare, did you? I don’t want any of that.’”
Of course, that’s exactly what they got — and it likely saved lives. “I have so many stories of people who got insurance for the first time and were able to get to the doctor and find out they had chronic health issues they knew nothing about,” Stevens added.
The irony runs deep. The same federal programs conservatives often criticize are the ones keeping their communities afloat. From health care access to disaster aid, it’s largely liberal policies — and blue-state tax dollars — that help make life in rural America possible.
Yet McDowell County voters overwhelmingly threw their support behind Trump again, choosing a man and a party that have long aimed to cut those very programs. And now, the consequences are setting in.
With Trump back in office, more than a million people across North Carolina are expected to lose their health care coverage. That includes many in McDowell County — a region already struggling economically and still rebuilding from a natural disaster.
Democratic voters often argue that their taxes help sustain these same red areas — funding rural hospitals, supporting schools, expanding broadband, and sending emergency relief to towns that would otherwise be left behind. The goal, they say, is simple: to make sure every American, no matter where they live, has a fair shot.
But in return, many of those same communities have continued to reject the very policies that sustain them. McDowell County’s story is both tragic and telling — a reminder of how political loyalty can sometimes come at a steep personal cost. They got what they wanted. And now, they’re living with it.