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Invest in Rural Communities

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Protect Health Care Access

People living in rural communities struggle to get quality health care. It’s too expensive, there aren’t enough health care workers and hospitals nearby, and fewer people have health insurance. We need to reshape our healthcare policy to support rural people.1

  • Support rural hospitals to stay open and provide quality care with a broad range of services. Rural hospitals provide essential health care, including emergency services, access to specialists, and alcohol and drug treatment. However, in 2023, half of rural hospitals were operating at a loss, and that was before the federal government cut over 1 trillion in funds for health care.2
  • Reverse recent cuts, and make it easier for rural people to access health care and elder care through Medicaid, Medicare, and the Affordable Care Act. Expanding Medicaid3 and increasing Medicare reimbursement rates are important ways to deliver improved quality of care in rural communities. Additionally, reforms that increase health care access for rural populations should be prioritized, such as making family elder and disability care reimbursable.
    • The 2021-2022 Congress improved health care access and empowered Medicare to negotiate prescription drug prices and save taxpayers money. The number of uninsured dropped in 2021 – 2023, while enrollment in the Affordable Care Act (ACA) marketplaces reached record highs in early 2025.
    • The 2025 One Big Beautiful Bill Act cuts $1 trillion in federal Medicaid spending over the next decade, which is projected to disproportionately affect rural areas to the tune of $155 billion. This health care cut poses an existential threat to the viability of hundreds of rural hospitals already operating on precarious financial margins. The law also cuts billions from the Supplemental Nutrition Assistance Program (SNAP), which will lead to rural people going hungry and produce adverse ripple effects throughout local rural economies, including reducing revenue for local grocers.
  • Ensure the Rural Health Transformation Program is implemented to minimize rural hospital closure and is not a giveaway to the most consolidated hospital systems.4
  • People are struggling to keep up with necessary medications while drug companies walk away with huge profits. The federal government should lower prescription drug prices and improve rural access to medicines.5
  • Rein in private equity’s takeover of health care in rural areas.6
  • Ensure our nation’s agricultural communities have access to critical mental health support by funding stress assistance programs and ensuring access to behavioral health clinics, health centers, rural health clinics, and critical access hospitals.7

For more on health care, see Affordable Prescription Drugs and Reproductive Health Care.

Notes

  1.  See “Medicaid Saves Lives.”
  2.  The Save Rural Hospitals Act preserves access to rural health care by ensuring fairness in Medicare hospital payments, creates opportunities for rural critical care facilities, and invests in rural health care services. The Rural Hospital Stabilization Act provides critical financial support to help struggling rural hospitals keep their doors open. The Workplace Violence Protection Act will help with health care staff retention and requires the Occupational Safety and Health Administration to develop an enforceable safety standard for health care and social service workers.
  3.  Instead of pursuing harmful cuts to Medicaid to fund trillions in tax breaks, Congress should lower health care costs and save money. See the Lower Costs More Transparency Act. Implement site-neutral payment reform for Medicare. Establish billing transparency and increasing oversight into hospital and health care systems including requiring hospitals to establish off-campus billing practices and reviewing hospital consolidation and its role in driving up costs of care throughout our entire health system.
  4.  The Rural Health Transformation Fund was created to offset the harms to rural health care by the 2025 One Big Beautiful Bill Act. However, the fund isn’t nearly large enough and the funding requirements are vague.
  5.  See Strengthening Medicare And Reducing Taxpayer Prices Act, the Lower Drug Costs for Families Act, and reform rural-specific programs like 340B.
  6.  See the Stop Wall Street Looting Act.
  7.  The Farmers First Act reauthorizes and expands the Farm and Ranch Stress Assistance Network.