The Rural Impact

In part one of this episode, Rural Education: Public Funds for Private Schools, Dr. Melissa Sadorf, Executive Director of the National Rural Education Association (NREA), joins Michelle to discuss the evolving landscape of rural education. Dr. Sadorf shares insights from the 2022-2027 NREA research agenda, highlighting the importance of spatial and educational equity and how policy decisions shape students' and communities' opportunities.   The conversation continues to focus on persistent and new challenges facing rural education systems and schools, including student funding disparities, teacher recruitment and retention, and limited broadband access that can restrict learning opportunities for those seeking to access virtual charter schools.   Moving to Policy Lifts and Let Downs - Dr. Sadorf describes the impact of the 2025 dismantling of the U.S. Department of Education's Office of English Language Acquisition (OELA) and the expanding, critical role of rural schools as hubs for health and wellness services.   The two also discuss the lift rural schools are receiving from an innovative program funded by a U.S. Environmental Protection Agency grant.   Before a break, Michelle and Dr. Sadoff discuss the complexities of school choice in rural areas, and looking ahead, Dr. Sadoff outlines key priorities for future research and policy advocacy to strengthen rural education systems and the communities they serve.   In part two of this episode, Executive Director of Blue Missouri, Jessica "Jess" Piper, returns to Rural Impact to take a closer look at the challenges and resilience of rural education in Missouri. The conversation examines how decades of public education underfunding impact rural districts, including contributing to larger class sizes, fewer resources, and increased pressure on educators. They also discuss efforts to expand school privatization and voucher programs that use public funds for religion-centered education, as well as how school-choice policies in Missouri are expanding, and what it could mean for public schools, including the quality of education K-12 students have access to and the economic impact on rural communities when choice creates fewer options for funding public education. 

In part one of this episode, Tracking Transformation: Opportunity for Some, for Others Pain, Michelle sits down with Executive Director and Co-Founder of the Center for Children and Families at the Georgetown University McCourt School of Public Policy, Joan Alker, as well as Dr. Shannon Dowler, who is a family medicine physician, serves on the Board of Directors for the American Academy of Family Physicians, and an expert leader in Medicaid programs and expansion. Michelle, Joan, and Dr. Dowler unpack the scale and scope of recent Medicaid cuts under H.R. 1, examining how nearly $1 trillion in reductions compare with investments in rural health and what that imbalance means for communities on the ground. They explore the disproportionate impact on rural populations and how these cuts intensify existing racial, economic, and geographic health disparities. The conversation breaks down the political landscape, separating rhetoric from the reality of rural health funding, and explains the mechanics of provider taxes, state-level Medicaid financing strategies, and how work requirements contribute to coverage churn. Finally, they highlight actionable strategies for healthcare providers and advocates to educate policymakers and the public, underscoring the urgent need to reverse federal Medicaid cuts and protect essential rural health services. At the close of the episode, Michelle shares some special excerpts from interviews she had while attending the National Rural Health Association (NRHA) Policy Institute, with NRHA CEO Alan Morgan and President Carrie Henning-Smith. Alan Morgan argues that the “slowing of growth” in Medicaid is effectively a cut that will harm rural hospitals, which are already struggling due to a high concentration of patients with complex health needs and limited ability to pay, not because of low volume or poor management. He emphasizes that Medicaid is the primary tool keeping rural hospitals open by helping offset uncompensated care and bad debt, and he urges postponing the proposed reductions. Dr. Carrie Henning-Smith adds that rural health policy must focus on strengthening the overall foundation of care, addressing longstanding disparities, stopping looming Medicaid cuts, reinforcing the safety net, investing in the workforce, and making temporary support programs permanent through statutory action.

In part one of this episode, The Inescapable Impact of Immigration Policies on Small Towns and Rural Communities, Michelle sits down with Emmy and Murrow Award–winning video storyteller, content strategist, and co-founder of 515 Productions, Lynn Melling, to examine how immigration policies and ICE operations are shaping life in small rural communities like Melrose, Minnesota. Lynn shares insights into the cultural, economic, and emotional impacts on residents, local businesses, law enforcement, and emergency services, and discusses how fear and silence often limit open community dialogue. The conversation underscores the critical role of storytelling and local journalism in bringing empathy, accuracy, and rural voices into the national immigration conversation.   In part two, Brian Depew, Executive Director of the Center for Rural Affairs, and Michelle explore how federal immigration policies are affecting rural communities across the country. They discuss the fear these policies create for immigrant workers, the resulting workforce shortages in sectors such as agriculture and healthcare, and the essential role immigrants play in sustaining rural economies. Brian also highlights growing bipartisan support for reform and the power of public advocacy to drive meaningful immigration policy change.   In part three, Michelle speaks with Betsy Froiland, a freelance reporter whose work focuses on rural faith communities and social issues, featured in The Daily Yonder, Barn Raiser, and MinnPost. Betsy shares reporting from Willmar, Minnesota, examining the personal and economic consequences of immigration enforcement in rural communities. The conversation explores fear stemming from ICE actions, ripple effects on families, schools, and local businesses, and the resilience and solidarity that emerge in response. The episode concludes with a discussion on the vital role of independent journalism and the need for policy change to better protect vulnerable populations. Resources:"Melrose" https://youtu.be/TVmNbIEXOc0?si=4mmydoK1yVFT7nx8Federal immigration actions affect rural communities, toohttps://www.cfra.org/blog/federal-immigration-actions-affect-rural-communities-too\"A Small Town Under ICE Occupation" https://dailyyonder.com/a-small-town-under-ice-occupation/2026/02/02/

In part one of the episode, Tracking Transformation: Great Healthcare Plan & Threats to Food Security, Larry Levitt, Executive Vice President for Health Policy at KFF, joins host Michelle Rathman. Larry oversees KFF's policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women's health, and global health.    In this conversation, Michelle and Larry Levitt discuss the current state of health policy in America, focusing on President Trump's recent healthcare plan, affordability challenges, and implications for rural health. They explore the complexities of healthcare funding, the impact of the ACA, and the potential effects of the Rural Health Transformation Fund. The discussion highlights the need for transparency and bipartisan cooperation in addressing these pressing issues.   In the second half of this in-depth episode, Michelle speaks with Gina Plata-Nino, SNAP Director for the Food Research & Action Center (FRAC). At FRAC, Gina collaborates with the SNAP team to expand the program's reach and improve its effectiveness for low-income households. She leads legislative and technical support efforts for national, state, and community organizations, as well as government agencies and nonprofits, to strengthen SNAP access, benefits, and customer service.    Michelle and Gina discuss the critical intersection of agriculture, nutrition, and policy, with a particular focus on the Supplemental Nutrition Assistance Program (SNAP). They delve into the implications of recent legislative proposals that threaten to undermine SNAP, highlighting the hardships they could cause for millions of Americans, especially in rural areas. Gina emphasizes the economic ripple effects of these policies, explaining how cuts to SNAP could lead to significant losses for farmers and local economies, exacerbating food insecurity and health disparities.   The conversation also addresses the broader implications of federal disinvestment in rural communities, including the strain on state budgets and the potential for increased poverty and food deserts. Gina articulates the urgent need for policy changes that prioritize access to healthy food and support for local economies. The episode concludes with a call to action for listeners to engage with their legislators to advocate for better SNAP policies that ensure food security and health equity for all communities.   Rural Impact Merchandise Has Arrived! Visit our Store and Order Your Gear   Show Resources: https://frac.org/actionhttps://www.kff.org/

In part one of the episode, Tracking Transformation: Funding Awarded. Now What? Michelle Rathman invites Grace Creek Advisors' Bob Atlas to discuss his analysis of the Rural Health Transformation Program (RHTP). Bob is an executive consultant in health policy and strategy, serving public - and private - sector clients nationwide on health care delivery and financing. The health care safety net is a special focus of his work. In their discussion, Michelle and Bob focus on the implications of the $50 billion funding aimed at addressing the challenges faced by rural healthcare systems. They explore the limitations of the funding, the importance of workforce resilience, the need for transparency in allocation, and the critical role of advocacy in ensuring effective use of resources. The discussion highlights the interconnectedness of rural and urban health systems and the necessity for a comprehensive approach to healthcare transformation. In the second half of this in - depth episode, Michelle speaks with Kevin Bennett, PhD. Bennett is a Professor of Family & Preventive Medicine at the University of South Carolina School of Medicine in Columbia, SC. He serves as the Director of the South Carolina Center for Rural and Primary Healthcare. He served as the president of the National Rural Health Association in 2024. His work focuses on improving healthcare delivery for marginalized and underserved communities, particularly in rural areas, while examining the influence of national, state, or local policies and legislation on these populations. The conversation delves into RHTP, discussing its strategic goals, implementation logistics, how it may address workforce challenges, and the importance of empowering rural communities, including cross - sector leaders, to become involved in how funds are invested to ensure they are used for transformation rather than "new toys." The dialogue emphasizes the need for sustainable access to healthcare, innovative care models, and the role of technology, while also addressing the cautious optimism surrounding the program's potential impact on rural health systems. Resources: Rural Health Transformation Program: Analysis of Funding By State

Every year, National Rural Health Day is a chance to recognize and celebrate the dedicated efforts of rural health advocates and partners working to improve rural life. On November 20, 2025, The Rural Impact celebrated with something special, a live, story-driven event that lifted the voices behind The Rural Effect.    Over the past two years, over a dozen Community-Based Organizations across Massachusetts led bold, creative, community-rooted work that rippled across 143 rural towns, resulting in expanded access, stronger trust, and lasting local change.   Rural Impact Host and Creator, as well as Rural Effect producer and storyteller, Michelle Rathman, brought together rural leaders who expanded access, belonging, and opportunity, along with staff from community benefit organizations reaching the most remote corners of the state, and leaders from the New England Rural Health Association advancing rural health equity, to share their stories in a special livestream event.    As we kick off a new year with a keen focus on tracking rural health transformation and other policies that impact over 60 million people, we invite you to listen to this special episode.     Every conversation offered something valuable, insight, hope, inspiration, and a reminder that rural communities hold extraordinary potential, and indeed are the #powerofrural.    Special thanks to Kirby Lecy, Jennifer Kimball, Ezekiel Baskin, Sarah Garvin, and Brea Corsaro. 

In part one of the last episode of 2025, 'Uncertain Times for Community Health Centers,' Michelle invites Feygele Jacobs, DrPH, MS, MPH to The Rural Impact. Dr. Jacobs is the Director of the Geiger Gibson Program in Community Health and Professor of Health Policy and Management at the Milken Institute School of Public Health, George Washington University. Previously, she was President and CEO of the RCHN Community Health Foundation, a non-profit dedicated exclusively to supporting and benefiting health centers and their communities and patients. Her diverse background includes positions in Medicaid managed care, public health care systems, and teaching hospitals. Summary Michelle Rathman speaks with Dr. Jacobs about the critical role of community health centers in the American healthcare system, especially in light of recent legislative changes such as HR1. They discuss the challenges these centers face, including funding cuts, Medicaid work requirements, and the impact of immigration policies on access to care. The conversation highlights the importance of these centers in serving vulnerable populations and the potential consequences of policy changes on healthcare access and quality. In part two of this episode, Michelle talks with National Association of Community Health Centers Chief Policy Officer, Joe Dunn. Joe is a two-time graduate of the George Washington University, Joe has spent the last twenty years in Washington, DC, on Capitol Hill and in a variety of government relations roles. Joe joined NACHC in January 2021 as Senior Vice President for Public Policy and Research from Cigna. Prior to this, he was in senior positions in three congressional offices, including Connecticut Senator Chris Murphy. Michelle and Joe discuss the critical role of community health centers in rural America, highlighting their contributions over the past 60 years, the challenges they face, and the importance of advocacy. They delve into the Rural Health Transformation Fund, workforce shortages, funding instability, and the need for innovative solutions to overcome geographic isolation. The discussion emphasizes the significance of community voices in shaping health policy and ensuring the sustainability of these vital health services.

In this episode, 'A Conversation About the Intersections of Policy and Philanthropy,' Cara V. James, PhD, President and CEO of Grantmakers in Health (GIH), joins Michelle to explore key topics like rural health funding challenges and the critical conversations shaping health policy.    Before joining GIH in 2020, James served as Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS) in the US Department of Health and Human Services, where she provided leadership, vision, and direction to advance health equity. Under her guidance, CMS developed its first CMS Equity Plan to Improve Quality in Medicare, its first Rural Health Strategy, created an ongoing initiative to help individuals understand their coverage and connect to care, increased the collection and reporting of demographic data, and developed numerous tools and resources to advance health equity.   In this conversation, Michelle and Cara talk candidly about how philanthropy can address health disparities, especially in rural communities, and the impact of government policies on nonprofit funding, emphasizing community engagement and leadership in advancing health equity.    The conversation highlights the need for a collaborative approach to improve healthcare access and population health, stressing the importance of systemic change and the freedom to give, encouraging listeners to consider how they can support these efforts. 

In this episode, "A Conversation About the State of America's Family Farms," Hannah Tremblay and Caitlin Arnold Stephano, both from Farm Aid, discuss issues impacting America's small and family farms.   Hannah Tremblay is Policy and Advocacy Manager, where they manage Farm Aid's advocacy program and engage a broad coalition in support of policies that strengthen family farmers and family farm agriculture. Hannah has worked as an agricultural technical specialist and a farmer throughout the Northeast and Mid-Atlantic since 2014.    Caitlin Arnold Stephano joined the organization in the fall of 2021 as the Hotline Program Manager. Caitlin grew up riding the tractor at her Grandfather's cherry and apple farm in Eastern Washington state, and has been working in agriculture, farmer organizing, and advocacy since 2006. Caitlin holds a Master's in Sustainable Food Systems with a focus on farmer mental health   In this conversation, Michelle speaks with Hannah and Caitlin about Farm Aid's mission to support family farmers, the implications of the ongoing stalled farm bill, the myriad of challenges farmers face, including economic policies that harm small farms, and the importance of community advocacy and supporting local farmers by purchasing their goods. Also covered in this conversation is the increasing demand for the Farm Aid hotline services, the impact of climate change and immigration policy on farming, and the need for improved disaster relief and support systems for farmers.    The conversation emphasizes the critical role of local and federal policies in sustaining small farms and the importance of community engagement in supporting farmers. 

In this episode, "Finding Common Ground in Community Engagement," Michelle welcomes Meredith Dean, the National Director of the Rural Urban Bridge Initiative's Community Works program, to discuss how rural communities are finding common ground and bringing people together, regardless of political differences, to address local needs. Meredith brings 40 years of experience in community organizing, Democratic politics, non-profit management, and teaching in both formal and informal settings, from adults to higher education to kindergarten. She and her husband settled 39 years ago in a ruby red Virginia county nestled in the beautiful Blue Ridge section of the Appalachian Mountains, where they raised their son, 13 cats, four dogs, and a horse. In this conversation, Michelle Rathman and Meredith Dean discuss the importance of community engagement in rural areas, particularly through the Community Works initiative. They explore the impact of national policies on local communities, the need for trust and collaboration across political divides, and practical steps for individuals to get involved in community improvement efforts. The discussion emphasizes the significance of addressing local needs, fostering relationships, and creating sustainable solutions for rural challenges. The episode emphasizes how sustainable engagement requires ongoing effort and commitment, and how cross-political collaboration can lead to practical and effective solutions.

In this episode, "Ready. Set. No. The State of Medicaid Work Reporting Requirements Readiness," Michelle welcomes Research Professors Tricia Brooks and Leonardo Cuello, as well as State Health Policy Analyst Hannah Green, all joining us from Georgetown University McCourt School of Public Policy Center for Children and Families, to discuss their report published on September 4, 2025 titled "Are States Ready to Implement HR 1 and Medicaid Work Reporting Requirements?"   In this conversation, Michelle, Hannah, Tricia, and Leo discuss the implications of the HR1 Medicaid work reporting requirements, focusing on state readiness, the impact on coverage for lawfully present immigrants, including the dispelling of misinformation on the matter, and the challenges that counties and rural communities, households, and economies can expect to face and manage in the months and years to come.  The discussion highlights the importance of states meeting quality performance indicators, how funding and staffing cuts can further undermine the achievement of even minimum standards, and explores strategies for community engagement with multiple parties, as well as the urgency of advocacy around the rising uninsured rate among children and the financial strain on rural hospitals.   The conversation closes with a discussion about data collection and transparency, noting that researchers rely on timely and accurate CMS data to inform and educate policy decisions.  This episode was made possible by our partner, the National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno.  Starting October 20, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes on the evening of October 19, so don't wait! Visit narhc.org to register.

In this episode, "A Conversation About What Undermines Local Government and Public Service," Michelle welcomes Brooks Williams to discuss how anger and rage are impacting local governments. Brooks is a city manager whose two decades span public and private leadership. He is known for turning strategy into results, such as stronger finances, healthier cultures, and clear metrics that track real performance. He serves the QTF Regional Program, a performance-excellence initiative that helps organizations apply the Baldrige Excellence Framework, continuous improvement, and disciplined measurement to achieve lasting outcomes. A doctoral candidate in Public Administration, with an MPA from Liberty University, Brooks also writes to move leaders from noise to substance. His books, Performative Outrage: How Manufactured Fury Undermines Local Government and Public Service and Rising to Serve: Reimagining Public Administration for a New Era, challenge institutions to prove value through measurable excellence, accountability, and public trust. Michelle invited Brooks to this episode to explore how anger and rage is impacting small governments. Together, they discuss the challenges and opportunities in public service, particularly in the context of performance outrage and the erosion of public trust. Brooks emphasizes the importance of transparency, civic engagement, and the role of social media in shaping public discourse. He advocates for a shift towards more constructive dialogue and the need for public servants to act as culture shapers within their communities. Brooks also highlights the necessity of civic literacy and education to empower citizens and improve local governance. This episode was made possible by our partner, The National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno!!! Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this episode, "HRSA's Dwindling Rural Health Commitments," we kick off with a conversation between Michelle and Alexa McKinley Abel, Director of Government Affairs at the National Rural Health Association. They delve into recent developments from the House Appropriations Committee related to the FY2026 Labor-HHS appropriations bill, which proposes significant investments and increases in rural health funding. The two also dissect a new provision in the Rural Hospital Provider Assistance Program, which, if passed, offers financial support to at-risk hospitals. They wrap up with a discussion that underscores the need for increased funding and the impact of community stories in underlining the importance of these programs. Next, Michelle welcomes Carole Johnson, former Administrator of the Health Resources and Services Administration, and current Senior Fellow at the Century Foundation. Michelle speaks with Carole about the current state of rural health, focusing on the challenges posed by workforce reductions, funding cuts, and the need for community engagement. They discuss the impact of these issues on healthcare services in rural areas and the importance of advocacy in securing the necessary resources in the long term. Carole emphasizes the need for immediate action to address funding gaps and significant cuts to HRSA's workforce, responsible for administering rural health programs, some of which have been eliminated or paused. In the second half of this in-depth episode, Michelle speaks with Toniann Richard, CEO of HCC Network, about the critical issues facing rural health organizations, particularly in relation to Medicaid and the Rural Health Transformation Fund. They discuss the challenges of navigating policy changes, the importance of grassroots advocacy at the state level, and the need for community engagement in health initiatives. The conversation also addresses vaccine hesitancy in rural Missouri and the role of public health in these areas in building confidence and capacity, highlighting the importance of providing reliable information and support to communities. This episode was made possible by our partner, The National Association of Rural Health Clinics and they invite you to rendezvous with them in Reno!!! Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this episode, Education, Workforce & Tariffs: Rough Roads for Rural Ahead, the episode begins with Alexa McKinley Abel, Director of Government Affairs at the National Rural Health Association, who provides a rundown of the Senate Appropriations Committee's markup of the 2026 Labor Health and Human Services, Education, and Related Agencies Bill. Alexa detailed what the markup means for rural health; many of the programs that were initially proposed for elimination in the President's budget are actually funded and funded at higher levels than in past years. She continued the conversation by providing some key highlights of the bill and concluded by noting that the House and Senate must agree on numbers and pass the same budget. It remains to be seen where the house will stand in the FY26 funding bill. Next, Michelle welcomes Dr. Jeff Strohl, Research Professor and Director of the Georgetown University Center on Education and Workforce (CEW). They discuss the challenges facing rural education and workforce development, particularly in light of recent policy changes and economic shifts. They examine the impact of AI on job markets, the significance of community colleges, and the challenges that rural students face in accessing education and training. The discussion highlights the importance of aligning educational programs with labor market demands, as well as the need for increased investment in career navigation and employer engagement to support rural communities. In the second half of this in-depth episode, Gbenga Ajilore, Chief Economist at the Center on Budget and Policy Priorities, joins us to explore the significant impacts of recent policy changes on rural households and communities, focusing on education funding, Medicaid and SNAP cuts, tariffs, and tax cuts. Gbenga shares how these factors contribute to economic challenges in rural areas, emphasizing the need for advocacy and storytelling to highlight the real-life effects of these policies. SHOW RESOURCES https://cew.georgetown.edu/cew-reports/bridging-middle-skills-gap/ https://www.cbpp.org/research/economy/the-republican-agendas-triple-threat-to-black-households-economic-well-being This episode was made possible by our partner The National Association of Rural Health Clinics. The National Association of Rural Health Clinic invites you to rendezvous in Reno!!! Beginning October 20th, the two and a half day NARHC Fall Institute features a powerful in-person agenda plus three pre-conference webinars the week before, it’s your chance to engage deeply with the pressing issues facing Rural Health Clinics today. With unmatched networking, and a throwback 90s Bash, you’ll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this Rural Impact Extra Episode: A Conversation about Rural Prosperity and its Connection to Policies, Past, Present & Future, Michelle leads the episode with a discussion with two esteemed experts in the field. Tony Pipa, a Senior Fellow in the Center for Sustainable Development at the Brookings Institution, and Brent Orrell, a Senior Fellow at the American Enterprise Institute(AEI), bring their wealth of knowledge and experience to the conversation. Tony, Brent, and Michelle discuss the Brookings-AEI Commission on US Rural Prosperity, a significant bipartisan endeavor. This commission has a shared mission to enable rural prosperity in the 21st century by strengthening economic opportunity, resilience, and quality of life across rural America. Drawing on rigorous analysis and informed by a series of research symposia led by Brent and Tony, America’s Rural Future will share regular insights through policy briefs, public events, and narrative storytelling, informed by site visits and conversations with rural leaders across the country. The discussion explores the challenges and opportunities facing rural America, including economic transformation, workforce development in the age of AI, the importance of infrastructure, climate change resilience, health outcomes, and the need for effective governance and policy coordination. Together, they emphasize the crucial role of civic engagement and community involvement. This is not just a conversation, but a call to action for all those who care about the future of rural policy. In part two of this episode, Michelle is joined by Matt Hildreth, who serves as the Executive Director of RuralOrganizing and RuralProgress, a nationwide network of nearly one million advocates and civic leaders in small towns and rural communities that have successfully pushed for over $1 billion in new economic prosperity programs for economically disadvantaged communities. Matt and Michelle delve into the importance of empowering rural leaders, the impact of Medicaid on small communities, and the innovative 2050 Festival. This festival, aimed at engaging the next generation of civic leaders, is a beacon of hope for the future of rural America, inspiring optimism and confidence in the potential of our rural communities. This episode is brought to you by The National Association of Rural Health Clinics. NARHC invites you to rendezvous in Reno!!! Beginning October 20th, the two and a half day NARHC Fall Institute features a powerful in-person agenda plus three pre-conference webinars the week before. It’s your chance to engage deeply with the pressing issues facing Rural Health Clinics today. With unmatched networking and a throwback 90s Bash, you’ll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this extra episode of the Rural Impact Michelle welcomes Cynthia Wallace, Executive Director of the non-profit, New Rural Project, which she co-founded in April 2021 to discuss the impacts of H.R.1, as well as the how Cynthia and The New Rural Project are amplifying the voices of rural young people and marginalized residents in North Carolina so that they are heard and seen, and they get electorally and civically engaged. Before starting her non-profit, Cynthia spent over 25 years in financial services, retiring from Synchrony (formerly GE Capital) after 20 years spent there. She was the 2020 Democratic Nominee for North Carolina’s 9th Congressional District. Prior to running for public office, she was the Chair of the 9th Congressional District of the North Carolina Democratic Party. Cynthia was appointed in early 2021 to the NC State Banking Commission by Governor Cooper and serves on the boards of Democracy NC and the Levine Museum of the New South.  Michelle and Cynthia discuss the challenges facing rural communities, particularly in light of recent legislative changes. She shares her background and the motivation behind founding New Rural Project, which aims to engage rural voters, especially those marginalized in the civic process. The discussion highlights innovative strategies for community engagement, including deep canvassing, barbershop conversations, and empowering young voices in politics. Cynthia emphasizes the importance of listening to community needs and the impact of grassroots activism on local policy. The conversation concludes with a call to action for listeners to support rural advocacy efforts, become and stay engaged in local politics, and a warning about a rapid increase in voter suppression laws enacted across the U.S. in 2025. Show Resources: https://www.newruralproject.org/ https://votingrightslab.org/report/2025-legislative-sessions-to-date-key-election-policy-trends/  

Michelle kicks off this episode with Edwin Park, Research Professor at the Georgetown University Center for Children and Families, within the McCourt School of Public Policy. His work primarily focuses on Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act. Previously, he worked for 17 years at the Center on Budget and Policy Priorities, most recently as Vice President for Health Policy. He was also a health policy advisor for the White House National Economic Council, a Medicaid professional staff member for the U.S. Senate Finance Committee, and a health law attorney in private practice. In addition, Edwin served on the Biden-Harris Presidential Transition team. He is also a member of the National Academy of Social Insurance. During this conversation, Michelle and Edwin discuss the implications of H.R.1, also known as the One Big Beautiful Bill Act, focusing on the significant cuts to Medicaid and their impact on rural health systems. They examine the financial strain on rural hospitals, the challenges faced by states implementing Medicaid expansion, and the broader implications for communities across the political spectrum. The discussion highlights the importance of advocacy and accountability in response to these changes. In part two of this episode, Michelle meets with Shawn Martin, Executive Vice President and Chief Executive Officer of the American Academy of Family Physicians (AAFP), and Nathan Baugh, Executive Director of the National Association of Rural Health Clinics (NARHC). Shawn provides strategic leadership to the AAFP and directs the mission-driven work of the nation’s largest primary care organization. A strategic leader with a proven track record of accomplishments, Shawn is nationally recognized for his thoughtful leadership on a range of health care policy and workforce issues. While his career portfolio includes focused work on numerous healthcare and public policy issues, he is best known for his extensive work and national leadership on the development and implementation of primary care delivery and payment models, as well as workforce issues. Before becoming the Executive Director of NARHC in July 2022, Nathan served as the Director of Government Affairs. In this role, he was instrumental in the passage of the Rural Health Clinic Medicare payment reforms, which were signed into law as part of the Consolidated Appropriations Act of 2021. This legislation was the most significant overhaul to the rural health clinic program in the last twenty-five years. As Executive Director, Nathan provides strategic direction for NARHC and remains involved in RHC advocacy priorities, including telehealth and Medicare Advantage. With all eyes focused on legislation that will have sweeping implications for rural health clinics and physicians, Shawn, Nathan, and Michelle discuss the impact of stagnant payment rates and administrative burdens, differences between rural health clinics and FQHCs, the effects of Medicaid cuts, barriers to healthcare, challenges in recruiting and retaining healthcare professionals in rural areas, the importance of advocacy at the state level to mitigate the negative impacts of recent legislation, and strategies for healthcare professionals to engage in policy discussions and advocate for change.

In this extra episode of Rural Impact, Michelle Rathman begins the episode with Anthony Flaccavento. Anthony is a farmer and rural development consultant from Abingdon, Virginia, in the heart of the Appalachian Coalfields. The Founder of Appalachian Sustainable Development, he has focused most of his work over the past four decades on building healthier food systems and more diverse, locally rooted economies in Appalachia and around the world. The Democratic Candidate for Congress in Virginia’s 9th District in 2018, Anthony, co-founded the Rural-Urban Bridge Initiative, or RUBI, in 2021. A national organization, RUBI works to help progressives, liberals, and Democrats understand the underlying causes of the rural-urban divide and take concrete steps to win back rural and working-class people through education, media work, policy change, and local community action. Michelle and Anthony discuss several pressing issues facing rural communities in America, including the importance of understanding the rural-urban divide, building trust, and developing effective communication strategies to engage rural voters. Anthony outlines seven key steps for the Democratic Party to reconnect with rural America, emphasizing the need for local investment and acknowledgment of past policy mistakes. The conversation highlights the significance of grassroots efforts and the Rural New Deal as a framework for revitalizing rural communities. Michelle closes out the episode by sharing with listeners some of the impacts of the One Big Beautiful Bill that passed the Senate on July 1, 2025, highlighting the critical effect of proposed Medicaid cuts on rural hospitals and communities. She cites alarming statistics regarding funding reductions, potential hospital closures, and the broader implications for healthcare, education, and economic stability in rural areas. Michelle emphasizes the urgent need for advocacy and awareness among policymakers to protect rural America from detrimental legislative changes.

Guests: President of the Association of State Democratic Committees Jane Kleeb DNC People's Cabinet Member and Co-chair of Dirt Road Dems Chris Jones DNC People's Cabinet Member and rural policy expert Will Westmoreland DNC Midwestern Regional Chair and Chair of the Missouri Democratic Party Russ Carnahan In this Rural Impact special, "Candid Conversations" episode, host Michelle Rathman delves into the real-world and real-time consequences of the Trump Administration's and the 119th Congress' policy decisions on rural America with a panel of guests from the Democratic National Committee (DNC). In this wide-ranging conversation, Michelle and guests explore how the Democratic Party is working to reengage and earn the trust of the over 60 million rural Americans whose voices are often overlooked and discuss plans for how Democrats are working to reach the estimated 63% of rural voters who cast their vote for a Trump second term. Panel guests include President of the Association of State Democratic Committees Jane Kleeb, DNC People's Cabinet Member and Co-chair of Dirt Road Dems Chris Jones, DNC People's Cabinet Member and rural policy expert Will Westmoreland, and DNC Midwestern Regional Chair and Chair of the Missouri Democratic Party Russ Carnahan.   The conversation begins with Russ Carnahan exploring the challenges and opportunities in engaging rural voters with an emphasis on bridging the rural-urban divide. Next, Jane Kleeb addresses the adverse impacts of climate policies on rural communities. Following opening remarks by Jane, Chris Jones highlights the importance and relevance of diversity, equity, and inclusion, as well as the harms that eliminating such programs and funding would have. Closing out the first part of the conversation, Will Westmoreland shares the economic struggles faced by farmers and the implications of Medicaid cuts on rural health. Michelle then invites the entire panel to discuss several critical issues facing rural communities, including cuts to the Supplemental Nutrition Assistance Program budget and significant reductions to Medicaid; they also examine the impact of misinformation on rural voters, the erosion of public education, and the privatization of essential services such as the United States Postal Service. The episode concludes by emphasizing the importance of personal stories and building trust within communities to effectively advocate for policies that benefit rural families, as well as the importance of clear communication, building relationships, and the role of education in combating misinformation and promoting community engagement.

In this special “What’s Your Impact?” episode of Rural Impact, Michelle Rathman starts by speaking with Mindy Cook, National Senior Director for Rural Healthcare Quality Outcomes Research and Analytics at the American Heart Association National Center. The American Heart Association has been a partner of The Rural Impact, and this episode focuses on the impact of the American Heart Association’s Rural Health Care Outcomes Accelerator Program. Michelle and Mindy discuss the importance of improving cardiovascular care in rural hospitals, the challenges faced, and the initiatives in place to enhance quality and outcomes. Mindy shares success stories from participating hospitals and emphasizes the need for preventative health strategies to combat rising rates of heart disease. The conversation concludes with information on how rural hospitals can get involved in the program. In part two of this conversation, Michelle meets with Kallie Provost, Cox Monett Hospitals’ TCD Coordinator, to discuss the challenges and opportunities in rural healthcare, with a particular focus on cardiovascular care and stroke management. Kallie shares insights from her experience at Cox Monett Hospital, emphasizing the importance of evidence-based practices and community partnerships to improve patient outcomes. They explore the Get With The Guidelines Program and its impact on rural hospitals, highlighting the need for collaboration among healthcare providers and emergency medical services (EMS) to enhance care delivery. The Rural Impact thanks The American Heart Association for its 2025 sponsorship! The AHA believes that everyone, no matter where they live, deserves access to high-quality care. That's why they created the Rural Health Care Outcomes Accelerator, a program designed to help rural hospitals improve cardiovascular care and patient outcomes. The Rural Accelerator provides no-cost access to quality improvement programs, data-driven insights, learning collaboratives, recognition opportunities, and expert-guided education to support 1000 rural hospitals nationwide in delivering evidence-based care. Rural hospitals play a critical role in their communities. Enroll today and join the movement to improve rural heart health. Visit www.heart.org/ruralaccelerator to learn more.