Rural Americans are sick of watching their health care become more expensive, harder to access, and increasingly out of reach after Donald Trump and Republicans slashed more than $1 trillion from Medicaid and the Affordable Care Act (ACA) to fund tax breaks to billionaires and big corporations. Millions of rural Americans rely on Medicaid and affordable coverage through the ACA to get care, fill prescriptions, manage chronic conditions, and keep their families healthy. Republican cuts mean more people losing coverage, higher premium and out-of-pocket costs, and hospitals and providers being pushed to the brink. As providers cut services or close altogether, patients are forced to travel farther for emergency care, maternity care, mental health services, and routine treatment, creating a matter of life-or-death for rural communities.
Protect Our Care’s “Sick of It! Fix Health Care Now” campaign is channeling the frustration of millions of Americans who are fed up with a health care system wrecked by Donald Trump and Republicans. As Congress heads home for the August recess, “GOP Hot Seat Summer” is bringing the fight right to Republican lawmakers’ doorsteps by holding empty-chair town halls, organizing petition drop-offs, hosting accountability events, and highlighting stories from Americans harmed by Republicans’ devastating health care cuts. Rural Americans are sick of being asked to pay more, travel farther, and settle for less — and they’re making sure their lawmakers hear about it.
Trump and Republican Cuts to Medicaid Leave Rural Americans in the Dust. Roughly 66 million people live in rural areas across the United States, and 25 percent rely on Medicaid for health care coverage. Rural Americans face different health care challenges than those who live in urban areas. 4 in 10 people with Medicaid living in rural America suffer from a chronic illness, and they report poorer health outcomes and higher rates of poverty than their urban counterparts. Trump and Republicans’ cuts to Medicaid mean higher rates of uninsurance and funding cuts to already vulnerable providers and hospitals in rural areas and small towns. Nearly 2 million rural Americans are expected to lose their Medicaid coverage by 2034. These people will be left to delay treatments, leave medications unfilled, and wait till health issues become emergencies to seek care due to the cost of health care.
Rural Americans Are Facing the Brunt of GOP Premium Hikes.. More than 3 million rural Americans enrolled in health insurance through Healthcare.gov in 2025. Around 27 percent of farmers and agricultural workers get their health care from the ACA marketplace. People living in rural counties will see their premiums go up 28 percent higher than urban residents. Following Republicans’ failure to extend premium tax credits, people living in rural areas are seeing their premiums increase by hundreds and thousands of dollars and are losing health insurance at higher rates than their urban and suburban counterparts.
H.R. 1 Cuts Will Shutter Rural Hospitals and Clinics. Before the passage of H.R. 1, rural hospitals already operated on thin margins, heavily relying on federal funding through Medicaid and ACA premium subsidies to stay afloat. Over 45 percent of rural hospitals were already operating with negative margins. Republican cuts have made it even harder for rural hospitals to stay open, putting care even further out of reach. Since the passage of H.R. 1, Protect Our Care has tracked over 1,000 hospitals that have closed, made cuts, or are at risk of cuts or closure. Hospital closures have devastating effects on nearby hospitals and their surrounding communities. When nearby facilities close, patient volumes in emergency rooms increase, some up to 27 percent. Overwhelmed emergency departments also mean longer wait times to receive surgery, whether it is a coronary bypass to treat a heart attack or an emergency appendectomy. Delays in surgical treatment result in a higher likelihood of complications and greater mortality. Studies also find that ambulance transport times increase by 11 to 16 minutes following a rural hospital closure – a life-or-death difference for patients having a stroke, heart attack, or internal bleeding.
Republicans’ Rural Health Fund Is Unlikely to Bail Out A Single Hospital From GOP Cuts. Over 330 rural hospitals are at risk of cuts or closure after Republicans gutted over $130 billion from rural health care in H.R. 1. This year alone, states are set to lose $31 billion in federal funding cuts to the ACA marketplaces, but only gain $10 billion from the Rural Health Transformation program. According to KFF: “It is highly unlikely that any state will receive more money from the rural health fund than it will lose from the historic cuts to federal funding for health care in the 2025 reconciliation law and from other federal policy changes.” Jed Hansen, the executive director of the Nebraska Rural Health Association, said “Rural Health Transformation will not save a single hospital in our state. I don’t think it will save a single hospital nationally.” GOP cuts are crumbling an already strained infrastructure, expanding maternity care deserts, and leaving Americans from Iowa to Georgia more than 45 minutes away from the care they need. The consequences of the GOP cuts are already unfolding across rural America and will only worsen as deeper cuts to hospitals take effect in 2027 and 2028.
Meet Some of the Rural Americans Reeling From the GOP Crisis
In Humboldt, Nebraska, Ben and Paula Sue Steffen own a farm where they produce corn, soybeans, wheat, and hay. Their health insurance costs nearly doubled after Republicans ripped away health care tax credits. Because farming can be a dangerous industry, health care is a necessity in case of an emergency. “‘We don’t care about the fact that we may have to go to the doctor a few times a year or need a checkup,’ Paula Sue Steffen said. ‘We just need to be covered, because if something does happen, the numbers are just crazy. You have to be covered or you’re going to be in trouble.’” So, the Steffens chose a cheaper plan with a
$7,200 deductible. “‘It’s not a gold-plated plan where you get everything paid for,’ Steffen said. ‘It’s the kind of thing that’s not sustainable.’” [KCUR // Photo from Farm Meets Fork]
Last June, in Scott County, Minnesota, Jared Moening was crushed when the parking brake on his tractor slipped. He spent several minutes pinned under the tractor tire before being extracted, revived, and brought to Hennepin County Medical Center (HCMC). “‘HCMC and the whole team who put me back together, plus a miracle, is the reason I am still here,’ Jerrad Moening said.” HCMC is at risk of cutting services or closing following Republicans’ devastating cuts to Medicaid. “‘We truly feel like if we hadn’t been brought here and to a different hospital, the outcome may have been truly different,’ Jerrad Moening said.” [CBS News // Photo from GoFundMe]
Near Mandan, North Dakota, Bailey Graner has dropped her health care coverage after costs skyrocketed because Republicans ripped away the health care tax credits that helped her get coverage. Their minimum payment would have been over $1,000 a month. Now, Bailey says she can’t sleep because she worries about the risks. “‘Hopefully none of us end up in the ICU because this could have huge implications for us being self-employed farmers and ranchers,’ said Graner. […] ‘I don’t want to leave farming and ranching just to get insurance. I want to farm and ranch. But how can we make it work if health insurance is so expensive?’ said Graner.” [KFYR]