CHESTERFIELD — At the headquarters for the Hilltown Community Development Corp., Executive Director Dave Christopolis offers his own frank assessment of President Donald Trump’s tax and spending bill, dubbed the “Big Beautiful Bill” by the president.

“Taxpayers don’t really know what’s in these bills. They’re jamming things in there at the last minute, giving concessions and deals to people in different states,” Christopolis said. “It feels like a mafia government right now, and we’re just trying to advocate for the people who we know are going to be harmed the most, which in this case is going to be the lowest-income people in our country.”

The bill that Trump has urged Republicans in Congress to pass before Friday would result in cuts to social programs like Medicaid and food assistance, as well as to the federal Department of Housing and Urban Development. Organizations that service rural communities that make up the hilltowns of western Massachusetts are warning that the bill could have devastating effects on their local populations, which tend to be older and have a lower income than more urban areas in the eastern half of the commonwealth.

Marcia Estelle, who serves as president of the board of directors for The Maples senior housing apartments in Worthington, expressed concern about potential cuts to the Department of Housing and Urban Development in the bill, telling residents at a Select Board meeting Tuesday that it would be “impossible” to keep The Maples open if such cuts were to take effect.

“We didn’t know about this until 2½ weeks ago,” Estelle said. “We felt an obligation to let the town know, because this is an established place that has been there since 1983.”

Estelle said the CEO of The Maples’ parent company, Elderly Housing Management, had met with congressional lawmakers from Connecticut, where the company is based, providing letters from residents on how the cuts in the bill would affect them.

“I’m a 77-year-old and in failing health. Three times a week I must go for dialysis. I’m able to still live independently thanks to my housing subsidy, I have a son who also lives at The Maples and assists with my care and keeps me company,” one of the letters states. “The stress of wondering if I’ll have a place to live after October feels cruel and uncaring in a country as great as America.”

Right next to The Maples is the Hilltown Community Health Center, one of its two locations in the hilltowns (the other is in Huntington). They, too, are at risk of losing their ability to service local residents, according to Debra DiStefano, the chief people and compliance officer at HCHC. According to DiStefano, 44% of the health center’s fiscal year earnings came from Medicaid and Medicare.

“We have almost 4,000 patients that this would be affecting, with over 14,000 visits,” DiStefano said. “When we look at seniors specifically, that’s about 1,500 seniors that could be potentially affected by what is happening right here.”

DiStefano also provided data from the Massachusetts League of Community Health Centers, regarding how the bill would affect health center patients statewide. Medicaid reimbursement makes up more than 30% of health centers revenue in the state, and more than 380,000 health center patients are covered by Medicaid. Due to the additional work requirements included in the president’s policy bill, between 90,000 to 180,000 health center patients could lose their coverage, leading to a total revenue loss of more than $1 billion, the league stated.

“There is going to be great concern that because people are losing their insurance, they’re losing coverage, they’re going to be forced into the emergency departments,” DiStefano said. “And then the emergency departments are going to be overburdened because they will not be able to accommodate everyone.”

In a statement released Tuesday, Gov. Maura Healey pledged to use her own state budget to provide relief to residents affected by the closures, acknowledging the threat of closures to rural hospitals and community health centers.

“I want the people of Massachusetts to know that your Governor and your elected officials care about you. We want you to have health care, we want you to have lower energy bills, we want you to be able to afford a home, we want you to have healthy food on the table, we want you to have the very best education and transportation systems possible,” Healey stated. “That’s what the budget I’m currently reviewing will do. That’s what we are working to do here in Massachusetts every day.”

But Christopolis, whose Hilltown CDC provides affordable housing, food access and transportation services to more than a dozen towns between the Connecticut River and the Berkshires, said he worried the highly rural area might get left behind in a state of 7 million people where more than half live in the greater Boston area.

“All the weight is on one side. We got all of the land out here, but we don’t have the population,” Christopolis said. “Even in good times, it’s really hard to get an equitable distribution of resources to western Mass.”

Christopolis said he plans on working with the Rural Policy Advisory Commission, a governor-appointed team that makes legislative recommendations and of which Christopolis is a member, to try and advocate for the hilltowns at the state level amid the potential fallout of the president’s bill.

“I plan on leaning hard on that group during this Trump time,” Christopolis said. “I just think it’s really heartbreaking to be going through this right now, listening to what these guys are saying and debating this bill. It does feel like a really negative experience for everybody.”

Hospitals impacted

Other health executives in the state have weighed in on the impact the bill could have in the Pioneer Valley.

Laurie Martin, the chief financial officer of Baystate Health, which has hospitals and health centers in Northampton, Greenfield, Palmer and Springfield, told the Gazette in a statement that the bill is projected to cost their health system tens of millions of dollars.

“Hospitals, physicians, and providers will face the direct impact of the cuts which could result in reductions in programs, services, and jobs across our industry,” Martin said. “From what we have interpreted, it is projected to have between a $30 million to $50 million annual negative ‘bottom line’ impact on Baystate.”

A spokesperson for Cooley Dickinson Hospital declined to comment on how the bill would directly affect the hospital or the Mass General Brigham system to which it belongs, but provided a statement from Michael Sroczynski, executive vice president of the Massachusetts Health & Hospital Association, regarding the impact of the president’s bill.

“These bills would make it more difficult for people to maintain the coverage they need and make financing patient care much more challenging for local hospitals and health systems,” Sroczynski said in a statement. “It comes at a time when hospitals are already struggling with daily operations and as virtually every other sector relies on the strength of our health care system to succeed.”

SNAP impact, hunger

The bill also tightens requirements and makes cuts to the Supplemental Nutrition Assistance Program (SNAP), which provides subsidies for low-income households to purchase food.

Andrew Morehouse, the executive director of the Food Bank of Western Massachusetts, said in an interview he expected to see a “tsunami” of people seeking food assistance due to losing SNAP benefits.

“We’re already providing record levels of food to our region’s network of food pantries and meal sites,” Morehouse said. “We’re going to be really stretched to make up for the loss of SNAP benefits, and honestly, we won’t be able to replace the impact of SNAP benefits.”

Morehouse added that SNAP reductions could result in broader economic impacts, since many local farmers and food retailers rely on customers who pay using the program.

“It’s a very powerful stimulus to our local economy, and that’s no longer going to be in existence,” he said. “We’re already living in a time of a high cost of living.”

Alexander MacDougall can be reached at amacdougall@gazettenet.com.