Under that new federal rule, health care providers and pharmacists could no longer freely offer COVID shots to the public. Those who live in rural areas or areas with fewer hospitals or primary care clinics may have a harder time accessing a primary care provider and obtaining a prescription. Last week, two primary care clinics and an urgent care clinic closed that serve patients in the Shenandoah Valley. Augusta Health, which had operated those clinics, cited federal actions like forthcoming health care changes in the reconciliation bill Congress passed this summer as a contributing factor. But the closures still mean less of their health care footprint in the region, and hurdles for some of their patients.