Episode 61. A Conversation About Closing the Rural Urban Divide with Anthony Flaccavento
Michelle Rathman: Hello one and all and welcome back to a new episode of The Rural Impact. I am Michelle Rathman and I thank you as always for carving out time in your very busy schedule to join us for another conversation that aims to connect the dots between policy and rural everything.
Now in today's episode, I had the distinct pleasure of spending time with Mr. Anthony Flaccavento , whose name you may know, because he is the Executive Director of the Rural Urban Bridge Initiative. Uh, really appreciative for Anthony for joining me. It's a great conversation. I cannot wait for you to hear from him.
Now, in this conversation with Anthony, I just gotta remind you that it comes just after our special episode drop featuring members of the Democratic National Committee's, People's Cabinet, and before the Senate's all night session, debating the remarkably bad for rural America, GOP, tax and spending bill, which as of this hour on July 1st, that is the date I'm recording this intro for you. July 1st, 2025. It continues to hang in the balance as senators continue to work on amendments and closed-door negotiations.
So of course you are hearing this episode on July 3rd, and because I have no crystal ball, goodness knows, I wish I did. I can't predict, but what I can tell you with all certainty is that the One Big, Beautiful Bill or OBBB for short, if passed will. I'm seeing a lot of headlines that say could, but I'm gonna say will have seriously negative impacts on rural America.
Now, before I share some of the numbers, some of the bad news with you, the data and some facts, I do invite you to tune out that background noise. We know there's plenty of it, and put yourself in that podcast frame of mind and hear my conversation with the very wise and engaging Anthony Flaccavento. I am ready. I know you are too, so let's go.
Michelle Rathman: Hey, Anthony Flaccavento, Executive Director of Rural Urban Bridge Initiative. It is, I mean it when I say really great to have you here on The Rural Impact. Welcome.
Anthony Flaccavento: I'm delighted to be here with you, Michelle.
Michelle Rathman: Thank you so much. All right, well, before we get started, I do wanna remind our listeners that we are recording this day, this conversation on June 25th, and we are about a day or two away from learning the fate of Medicaid and many federal funding for dozens of programs for 60, 65 million rural people in America, depending on whose count you follow men, women, children, families, hospitals, schools, farmers, businesses, and so on. And it is through that lens that I have this conversation with you, Anthony, because there is a lot on the line as they say.
Anthony Flaccavento: Absolutely.
Michelle Rathman: All right. With that said, for those of our listeners who are not familiar yet with the work that you all do at the Rural Urban Bridge in Initiative, tell us, give us kind of a napshot of that, and from there, I wanna just go right into explaining the invitation for us to think differently, talk differently, and act differently to understand the causes of the rural urban divide, and then do something to repair it.
So tell us all about it. What do we need to think, talk and act differently about?
Anthony Flaccavento: Thanks for that open invitation. I'll try to be concise, Michelle. RUBI started just a little over three years ago. I had run for Congress. I'm not historically a real political person. I farm and I've done rural economic development work for most of my life, and at some point I thought, dang on it, the politics and the public debate are just going in the wrong direction.
So I need to do something on a bigger scale than the local work I'd been doing. So I started reading and then reaching out to authors like Arlie Hochschild, who wrote, uh, "Strangers in Their Own Land," and Kathy Kramer, who wrote "The Politics of Resentment" and Erica Edelson who wrote "Beyond Contempt" and others, and I sent them emails.
This was late 2020, going into 2021 at this point. I said, “what you said really resonates with me. Uh, here's me, you don't know me, but we should work together.” And amazingly, all three of them said, “yes.” So it took us about a year to get rolling, but later in 2021, we launched RUBI. And our basic most basic purpose is to improve the prospects for rural and working class people, economic community, and other.
But in the process, to also change the nature of our politics and our public debate because we feel like the divide this profound and pervasive divide between city and country, rural, urban, red and blue is not just bad for the communities that are now living under one party rule with the Republican party. But it's really undermining our whole political system.
So we set out to do something about that. Essentially we go about that in three ways. EAll of which fit into this framework you mentioned of thinking, talking and acting differently. We have education and training that we do. We do monthly briefings as well as trainings that we take to people all over the country.
We do public policy work, along with Progressive Democrats of America. We wrote a Rural New Deal, which we think is the best public policy platform out there for really rural revitalization, and we do grassroots on the ground community engagement work through our community works program.
Michelle Rathman: Yeah, and we will talk, we'll talk more about that later. But I mean, it's fascinating. I first learned of you when I just signed up and joined a call. And I felt just personally inspired and also I was around other people who were seeing through all the rhetoric and really had deep, deep, deep concerns.
And with that ideas.
Anthony Flaccavento: Yes. Yes.
Michelle Rathman: very different than just talk, but action.
Anthony Flaccavento: Right, right. We've, we've been committed to action from day one. At the same time, we feel like there is a piece that we have to, we have to improve our understanding. I've encountered a lot of times when, uh, liberals or progressives or Democrats, they're just like, forget the talk. Forget that. Let's just, let's just get going in rural areas.
Well, that's my inclination too. But if we don't understand how we contributed to the divide. How some of the public policies we supported on trade, on antitrust, on economic development contributed to the anger, in these communities. If we don't understand how our language alienates people, then just doing stuff ain't gonna be as constructive as it could be.
So that's where we have that framework. Gotta think about things a little, but then immediately move towards talking and acting differently.
Michelle Rathman: And talking doesn't mean taking to social media and firing off some, you know, nasty words in a post.
All right, Anthony, I wanna talk to you a little bit about the divide because, um, I said in our last episode, you may have seen it where we did a DNC round table. We were invited to have four members of the People's Cabinet. And in my introduction and I, and I mean this, I really wanna wake up one morning, and I know it's impossible at this moment to think about this, that we no longer have a red state or blue state. You know, all, both those colors are represented on our flag and the divide. I feel, I'm an optimistic person by nature, but I, I feel that the divide has really just expanded exponentially. So let's talk about that from its historical perspective, from your perspective, and then bring us to where we are today. The divide. Just a couple of ideas about the political, cultural, economic aspects between rural and urban slash suburban, because there is a lot of really bad feelings out there about that divide. So I'm very curious about some ways that you can enlighten us on that.
Anthony Flaccavento: Absolutely. Let me start with, um, a story. From one of my campaigns, I actually ran for Congress twice. My, my wife says I'm a sucker for punishment.
Michelle Rathman: Good on you.
Anthony Flaccavento: But the first time I, first time I ran, uh, was kind of a last minute. I threw my hat in the ring. It was 2012. I was running for Congress. It was the first of two times and it was actually April of 2012, and I had just pulled up at a restaurant in a tiny little town in Russell County, Virginia, called Lebanon, and there was about 50 people waiting to hear my stump speech.
When I parked the car, a gentleman greeted me, an older man. I recognized him 'cause he'd been at several of my events. He was a retired United Mine Workers, so he was a, he was a miner who had been with the UMWA. And first thing he said to me was, what do you think about that bombshell Obama's dropped on us? And I wasn't sure what he was talking about.
I thought maybe it was some sort of an environmental issue. So I said, “well, what do you mean?” And he said, “you know, gay marriage.” And I said, “oh, well what do you think about it?”
And he started in, he said, “well, the Bible says it's an abomination.” And he went from there, just the Bible says this and it's not natural, and marriage is between a man and woman the whole bit.
I let him have his peace. We're walking to the the restaurant where I'm gonna give my pitch. And when he was done, I said to him, well. I hear what you're saying. I know it's kind of odd for a lot of people, I said, but you know, the main thing I get from the Bible is we're supposed to love each other, especially the people that are hard for us to love, the people that are really different from us.
And he just thought on that for a moment and then he said, I guess you're right. And then unprompted, he said, “well, I suppose they're just born that way anyway.” So here's this old retired coal miner. Absolutely no college degree. Probably didn't finish high school. Who went from homosexuality is an abomination, to people are just born that way and I'm supposed to love him regardless.
And the reason he traveled that distance in about two minutes was because he trusted me, because he knew I was a guy who had been on the picket lines with them during the Big Pitton Strike in 89 and 90. He knew I had worked on black lung. He knew I had worked on jobs. So that trust is what we have lost by hollowing out the economy of so many small towns and rural areas and factory towns.
We created the environment that the right has then filled with finger pointing and anger. The grievances that people have, have been neglected and their right to be angry, but because we were not there for the most part, we on the left to respond to those grievances, to recognize them as legitimate. The right became the spokesperson for that. When Donald Trump, liar that he is, but when he said, I'm for the forgotten Americans, that resonated with people so given.
Michelle Rathman: even though all evidence to the contrary right now.
I don't know about you, Anthony. I listened this morning and I shared it on social, and again, because of the date we're recording this, I wanna note it. But I read a piece today in the Washington Post that was one of their like, deep dive stories about a farmer in Colorado. I fought back every single tear just getting through. It was a 40 minute, listen, I, I just. People are recognizing right now, as Will Westmoreland has said they've been, they've been lied to, and I think we have a, a big, big hole to dig ourselves out of.
Anthony Flaccavento: Absolutely.
Absolutely.
Michelle Rathman: that, let me, lemme just, just say there, you know, and you all do such a good, amazing job. Good is an understatement.
There is an all too common pervasive belief that urban and suburban liberals view rural America as irredeemably racist, and you just put any other label on it, you know, backwards, all that. And on the flip side, that rural conservatives and moderates view urban liberals as snobby, elitist, who look down on them, lack morality and common sense and seek to impose.
So the only time I will ever say, what about, what about, is that, all we know is that there are, all sides have deep misunderstandings, misperceptions, all formulated based on influences around them. So with that, I wonder if you could talk a little bit about how we begin to tackle what, I mean you, you guys have a wonderful resource out there called Talk Like a Neighbor, and I'm curious if you could talk to us about that.
I wanna skip to there and then give us some examples of how what you just shared gave me goosebumps, 'cause it was just a very simple exchange and yet so impactful. How do we begin to be at a place where we can stop labeling each other as these really negative, awful, evil creatures on either side and start to see each other as human beings?
Anthony Flaccavento: Which is what that gentleman saw me. He saw me not just as a human being, but a friend, an ally, which is why he was able to consider a deeply held belief and see it in a new light. I mean, it's just, that's what it takes.
So I think what, where we're at with this is that the starting place for the left is to recognize we've made mistakes that we've gone wrong. We've made policy mistakes. We've disinvested from rural communities. We often don't run candidates. All of that. And simply saying, why don't these people vote for us? They're voting against their own interests. That does no good. That doesn't help.
So if we, if our starting point is maybe we've been part of the problem too. Let's look at where we've gone wrong. That's kind of RUBI's thing. Then we can begin to see how to change that. So in Talking Like a Neighbor, which was written primarily by Erica Edelson, our, our brilliant, uh, board member and a RUBI Co-founder.
We have certain principles that we lay out, but it comes down to maybe three things, essentially. Number one, talk about local things, whether you're a candidate or you're an activist or you're organizing, talk about local concerns. When you look at the signs in the protests' march that are happening since Trump was elected, and Lord knows tons of stuff needs to be protested, and fought.
But they're very rarely about local issues. They're about big issues. Democrats, Liberals and pProgressives are attracted to big issues, which to a lot of local people feel either less important or kind of alien. To win back trust, they need to know that we care about local issues as much as they do.So number one among the talking thing is just what do we talk about? Let's talk about things that people wanna talk about.
Number two is to get away from the damn rhetoric, the techno speak, the social justice speak, the the academic speak and talk like a neighbor. That means using simple, straightforward, everyday language to every degree possible.
And then number three is to use concrete examples. Oftentimes, not only when I was running for office, but when I've organized farmers in a number of different ways in this region. If you start with something, someone, some business that everybody kind of knows. You build back from that to talk about an issue, then you have much more chance of connecting with people.
If you start at 30,000 feet with big abstractions, big principles, it's you tend to lose people. They, they think it's, they think it's deceitful. They think it's, you're trying to pull the wool over their eyes, or, or you're just, you're just talking out the side of your, your head. If you start locally, and I'll give you an example of that, then you can, then you can build back out.
So we were, we were fighting at one point this idea that so often we subsidize giant corporations to come into rural communities, millions and millions of dollars. We give big corporations who are already so big. We almost never give it to local businesses. So when I was talking to conservative people in my area about that, uh, this was a few years back, I said, “Hey, did y'all hear about that, that Cabelas that's coming to exit five?”
And they said, “yeah, yeah, I heard about it.” I said, “you know, they're, they're getting $50 million of our money of taxpayer money to come in.” Well, they weren't happy about that. I said, do you know that the, the person who won of the year award in downtown Bristol, do you know how much they got for winning being best entrepreneur of the year?
$5,000. I said 5,000 a hundred thousand, less, a hundred thousand times less than 50 million. So I use these very concrete examples to then be able to talk to 'em about what a mistake it was to dump all this public money into subsidies of big corporations. You can do that whether you're talking about health and Medicare housing, downtown revitalization, you can do that if you look around and it connects with people in a way that the abstractions don't.
Michelle Rathman: You bring up an excellent point because everywhere I travel, you know Anthony, for folks who listen to this show they know my work is my day job, as they say, is in rural health. There is no place I'm going today. And I did the full state of Massachusetts drill. The, I had someone, take me through the full state of Massachusetts, the State Office of Rural Health Kirby Lecy, we love you.
And everywhere we went, there were two very core and then many other issues, but two core nutrition assistance, food access, and transport. Well, those three, transportation and housing. Those things seem to me like, yes, they're big, but they have such a tremendous local impact. So, I think you're right.
I mean, just I said to Jane Kleeb we're, we're not asking people enough questions. We really wanna tell them what we stand for. And go to that 30,000 feet versus asking questions such as, and I would be curious what your thoughts are. What do you think about the fact that our local hospitals very close to not being able to keep its doors opens, door opens, and with that, might there something you can do to help come alongside them?
And, you know, I don't know if you used the word advocate for, I'd be curious about how you might switch off that language. And I'm guilty of it. I admit it as a communicator I wanna find good words, but sometimes, you know, without being condescending or what, have anything like that, how do you connect with people?
And, and my, my question in that would be how do you know when you made that connection with them, the gentleman that it was a great example of the miner who said, “aha, well maybe they're just born that way.”
Anthony Flaccavento: Yeah,
Michelle Rathman: What are some of the examples you can give us where you know that you've really landed an opportunity to cement a relationship?
Anthony Flaccavento: For sure. I mean, the, a big part of it is language, but you have to always remind yourself that if you become too self-conscious about language and you're trying to be somebody you're not, that you don't want to get in that spot, right? But bigger than language, language is downstream from that trust building, and the trust building only comes slowly. Through being present, through working together, not trying to fix other people's problems, but working side by side, literally or figuratively.
And, and in doing that, the language you use is still very important, but it's less important. Because again, if somebody has seen you, as they do in our community works initiative, out there, along with members of their church bagging food for senior citizens that are in need or picking up trash to clean up the park or fixing a roof on somebody's house.
If they see you turning out for that stuff, the words you use are still important, but they're not gonna greet your words with heightened skepticism.
They're gonna be like, oh. There's Michelle. I just saw her the last couple of weeks ago and she was out there driving nails to fix that house for old, old man Robins. So, it just changes the reception we get. So that is the most important thing, but language is still important.
So again, what we have to do, I think is, is just try not to use jargon. Jargon is the worst. Jargon is just the worst. And you know, you could say, I wanna advocate for the rural hospital. Or you, you could just say, you know that hospital, I know you go there, I go there. You know, it's at risk of closing. We need to stand up for it. It's gonna close, if this bill passes, we need to stand up.
So standing up is the same thing as advocating, right? It's just another maybe slightly more familiar way of saying it.
Michelle Rathman: Yeah, I always say understand your audience. I mean, understand, you know, what's important, what's important to them. Anthony, I wanna switch to another subject here because this is what really compelled me to make sure we had this conversation in this, in this moment.
In February of this year, 2025, RUBI sent a letter to Ken Martin, DNC Chair and fellow DNC officers, along with an addendum that highlights your assessment of the most important causes of Democrats losing trends while also proposing seven, very practical, in my view, promising steps most likely to reverse Democrats decline in rural America.
And that is not just to say we need to win, that is to say we need to set a new course for rural America. Because things are not looking good right now. Where, where that is concerned. So, give us an overview of the message and then let's talk through the seven steps.
I have it right here. I would love to have you share that with our listeners.
Anthony Flaccavento: Sure. And that's well put. We need a new course. Absolutely. 'cause again, it took losing many times for the left to kind of say “maybe, maybe we've got a problem with rural and working class people,” but many people are still at the point of recognizing that we have a problem, but they're not at the point of thinking we need to set a new course.
They're just thinking, we need to spin it better. We need to persuade these damn people. What's wrong with 'em? Yeah.
Michelle Rathman: thank you.
Anthony Flaccavento: So.
Michelle Rathman: that's what I say. We have to shift.
We have to make a shift.
Anthony Flaccavento: Absolutely. So here's the good news. One of those seven steps, perhaps the most foundational is coming to pass. I met with Ken after the letter was shared and 450 signatories from across the country.
I met with him in mid-April, and we have a call in mid-July, late July actually, that Ken will co-host with RUBI, with Contest Every Race and with Sarah Janes, who's a huge advocate for rural communities.
And we will co-host the call to launch a rural investment fund. To launch a rural investment fund so that donors to the DNC can indicate that they want some or all of their contribution to go into this rural investment fund, which will then be used to build capacity in rural and working class communities, funding the local democratic committees, funding groups and organizations that know how to talk to rural people, know what the issues are, et cetera.
And so, that step. We don't have any money yet, but we have a commitment to a call and we're right now in the process of starting the promotion. So that could be huge because
Michelle Rathman: And that is your first recommendation? Invest in local and state parties.
Anthony Flaccavento: Exactly, exactly. So that's, that's part of that, that new course. It's transforming the party from the bottom up, but it's only one step.
We also talk in that about the fact that we need to create these opportunities for local engagement. We mentioned community works as one of the strategies for doing it, but if you think that part of the problem STEM has, and I'll tell you that Ken Martin absolutely recognize this without me giving him any prompts that if you only show up a month or two before elections and then you're gone for 22 months, how are you ever gonna win people over?
So one of our recommendations is that we move away from electoral cycles and do year round organizing that's focused on community engagement, that's focused on solving local problems like that.
And so he's, again, very, very supportive of that. We just now need to turn that into both financial support, but also simply getting more local Democrats and others to recognize this as a possibility. What we've found is that when Democrats in rural communities where it's maybe 75- 25 red to blue at this point.
When they hear about community works and they hear that in the name of being a Democrat from Scott County, Virginia, they can do constructive things with their neighbors and maybe begin to reduce the mistrust and win hearts and minds. They're thrilled about it. So that that community engagement, community works piece is another part.
A third, and I'm not going in the order.
Michelle Rathman: Yeah, no. Yeah go ahead.
Anthony Flaccavento: A third is around public policy. So again, we lift up our own Rural New Deal as an example. We're not saying that that has to be exactly what's done, but the fact of the matter is that the party, slowly but surely over the last 40 years, has drifted away from a party that understands and knows what it takes to support working people towards a party that is primarily driven by and focus on the needs of the highly educated, the college educated.
We, the Rural New Deal is one example. Rural Democracy Initiative and others have also created policy documents that would really reverse that trend that would level the playing field for small businesses, for working class people. It would help revitalize manufacturing. Actually the Biden Administration for all the critique at stake and had, had taken a number of the policy steps that we recommended in the Rural New Deal.
Michelle Rathman: And funded them.
Anthony Flaccavento: And funded them and they've largely been reversed at this point.
But, but putting that front and center is both good politics. Like here we are in the middle of this resistance when the only thing people hear from the left is how horrible Trump is. And he is horrible. What if, they weren't just hearing that, but there was a, there was a press conference and 50 leading Democrats embraced a Rural New Deal to invest in these.
I mean, just think about the political positives from that and it's good policy. So that's a third one of our recommendations. A fourth and I'm going, I'm going from memory 'cause I don't have it in front of me. A fourth is a very simple one. It's an internal recommendation for the DNC and it is to hire permanent year-round rural staff. Not a lot, but hire at least a couple of people at the top who, who manage the rural part of the DNC's work, who get to know people doing great work all over the country, like Cynthia Wallace in North Carolina or Bill Hogseth in southwest Wisconsin, get to know them and begin to let what they know from their rural experience trickle up to the DNC.
So we recommend that they begin staffing it, because the fact of the matter is that during the Harris campaign, they hired a Rural Coalitions Director. She was fantastic. But yeah, Brie Bree Maxwell,
Michelle Rathman: Yep. I, I, interviewed her.
Anthony Flaccavento: she's terrific, but she was hired four, four and a half months before the election, and she was, she was gone a week after the election.
That's, that's got to change. We have to show that we are institutionalizing these, these steps.
Michelle Rathman: Because the work of organizing is nonstop and not organizing for the sake of just beating. Again, it is for changemaking and there are so many organizations out there serving rural that are changemaking, and I tell folks all the time they know this. This podcast is about connecting the dots between policy and rural quality of life.
And so listen, if someone can say to me, “Hey, Michelle, this policy that, that's passed by whatever party.” I mean, just show me, show me the receipts and, and show me how the policy is in fact harming or helping, uh, rural America. Another thing that you have on here, which I found interesting, and it's the shortest paragraph on here.
Apologize for NAFTA and other disastrous policies. Let's talk that for a moment.
Anthony Flaccavento: Yeah, I mean that's, I said I think earlier in, in our show right now that Democrats don't get anywhere when they say, we're the party for you. Why don't you get that? Instead, if we start by apologizing for NAFTA and maybe just our bad policies more broadly, we would open doors when I was campaigning, and I would say to people very candidly this was a policy supported by Democrats and I don't agree with it at all. It was a big mistake.
Then conservative people would pause and the skepticism about me as a Democrat would begin to recede a bit. So we have to, we have to acknowledge that for two reasons. We have to acknowledge it because one, it was a big mistake. Not just NAFTA, not, not just the other World Trade Organization, entry of China, but many other things.
One, one of the biggest mistakes we made during 16 years of Bill Clinton and Barack Obama was, we let corporations become even bigger and more powerful. We did not enforce antitrust laws. Now neither did the Republicans, but we should have been doing that. And so when we recognize that. Then we put forward a slate of policies that are not about trickledown economics.
They're not about neoliberal trade, but they're about investing in and building diverse, healthy local economies from the bottom up. People will listen to that bit by bit. Not everybody, of course, because we start with saying, “we screwed up. We were part of that. It was a bipartisan betrayal of your communities like yours, and we're gonna change that. Now we're done with that kind of neoliberalism.We're working now on building real prosperity from the bottom up.”
I think that's maybe the single most important thing we can do, but it, it has to be just one of the steps because policy alone in such a polarized environment just doesn't grab people's attention. It has to be part of the larger effort to build trust.
Michelle Rathman: Yeah, because I find that there is, people look at policy on politics. I mean, I recognize they sound the same in many ways, but at the end of the day, the politic part of it is the nuances, all of that. But the policy part is what's written in stone.
And to your point, if, if, if all of that work that we would not have multi-billionaires running the show everywhere we can look around this country. Oh my gosh, Anthony, we should prepare a meal and sit down and have this conversation more often.
Before I let you go, I do have a closing question for you, and I ask this if everybody who's willing to answer.
Advocacy is so important. It's the way that we move things. You could say pressure, whatever you wanna say, but I do know that it does move the dial. What tool or strategy do you have in your toolkit that our listeners can take with them to advocate to advance equitable rural policy? And I have said this before, you'll have to rip the word equitable out of my dead cold body.
I'm going to keep saying it 'cause I believe it to the fiber every core of my being understands equity means and why it is imperative that we do not let this drop out of off our radar screens because someone says it's a bad word.
Anthony Flaccavento: Right, Yeah. That's another whole conversation, isn't it? About how the right has just made anything to do with equity, diversity, I mean the, the most basic kind of core concepts of a fair society, and they've turned them all into, cuss words.
But I think, you know, there's a lot of different things and, and I would just really hope that a lot of your listeners would simply go to the RUBI website 'cause it's a good website that's easy to navigate.
They can, they see, we have podcasts, we have videos, we have a bunch of things. But I think the single best tool that we offer at this moment is the Rural New Deal. That was written with Progressive Democrats of America, Alan Minsky and I, but it really came out of about a dozen and a half leading experts on community economic development on the ground, not academic experts, people making it happen all across the country.
So if they go to the Rural New Deal, what you'll find is a pretty short document that's very easy to understand, that has 10 pillars from housing and healthcare to agriculture, all kinds of things. Mostly rural, some not. And each of those pillars has very specific real-world recommendations for what we need to do.
If we have people on the left by the thousands talking about the Rural New Deal, writing letters to the editor, doing social media posts about why this is the time for it, we would begin to elevate it. And whether the whole rural new deal ever comes to pass, simply talking about it and getting some of the elements into the public discussion, I think would be a tremendous service. So it's on our website, theruralurbanbridge.org, and I would love it if people would go take a look.
Michelle Rathman: Well, you better believe we're gonna put all of those resources links on our website, the rural impact.com, just in case pretty easy to remember. Anthony, you are welcome to come back and have a conversation with me anytime, and I would gladly cook you a meal sometime.
Anthony Flaccavento: It's gonna be a throw down. Michelle. I wanna cook for, I wanna cook for you.
Michelle Rathman: All right, well, we'll have to trade recipes. Anthony, again, thank you so much and for the rest of you, please do not go anywhere because this dot connecting conversation, it is not over. We'll be right back after this brief message.
Michelle Rathman: Thank you for staying with us. Thank you again to Anthony Flaccavento for sharing all the information that he did. As a reminder, we will make sure that we have links to all the resources that he talked about on our website, theruralimpact.com. We make it really easy for you to find. Now, as I promised you before the break, I said I was going to share some important data and figures with you.
And as you've heard in previous episodes, I have had plenty of conversations with several experts in the areas of rural health, housing, education, of course policy. And so I have been on a nonstop mission to keep myself informed of what the Senate's version of the OBBB would mean for rural families and children, how it would impact healthcare and hospitals, rural communities, and economies.
And here's just a few data points and facts that I believe are critically important to share. Again, not knowing where things have landed at this point, but where we are today on July 1st. Here's just some important information for you to understand as you consider making a phone call to your member of Congress and talking to them about how the bill will impact your, you, your family, your rural community, and so on.
So here it goes. As for proposed Medicaid cuts and the impact on rural providers, now this is from the National Rural Health Association. Uh, here's some of the, here's some of the figures that they provided. On average, rural hospitals are slated to lose 21 cents out of every dollar they receive in Medicaid funding.
And this is important because, again, you may know this already, so many rural hospitals, the majority of their patient population are on Medicaid. That is a major form of payment of reimbursement for the services they provide. Total cuts and Medicaid reimbursements for rural hospitals including both federal and state funds over the 10-year period, covered by the bill would reach almost 70 billion.
That's with a B for hospitals in rural areas, the Senate's bills cuts to rural hospitals are more than 15% greater than the already highly damaging $60 billion in cuts under the house version of that same bill. We've been saying just when we thought it couldn't get worse, it did. Medicaid cuts would place significant financial pressure on hospitals in rural states.
I can attest to this. I know this firsthand where many hospitals are already at risk of closure. In more than half of the states reductions in Medicaid funding for rural hospitals would exceed 20%. A few examples in Missouri where one third of rural hospitals are at risk of closure would see a 29% reduction.
Other states would also see large rural hospital Medicaid funding losses, including 21, excuse me, 27% in Montana, 25% in Nevada, 22% West Virginia. Now in Kansas where more than half of rural hospitals are at risk of closure, they would see a 15% reduction in total rural Medicaid hospital reimbursement. There is more state by state data.
Again, we're gonna put some links on our website so you can read it for yourself. But the message here is that reductions in Medicaid funding of this magnitude will accelerate rural hospital closures. We've been setting the alarms for many months now, and for those borough hospitals that remain open.
Listen, it's gonna lead to the elimination or curtailment of critical services such as obstetrics. We can at least afford that. We know we have OB deserts all over this country in rural America. It would also jeopardize chemotherapy programs, behavioral health programs, so on and so forth. And I already know that hospitals are bracing, for change, and that means some layoffs have already started.
And there's all sorts of implications for rural economies when that happens. So,. on average states where 40% or more of rural hospitals are set, again, at risk of closure, would see Medicaid rural hospital funding reductions up more than 20%. Bottom line hospitals are going to be hit from all sides of this equation because the Senate Finance proposal would reduce Medicaid funds to rural hospitals by 21% and result in over a million rural enrollees losing Medicaid coverage off the bat and likely becoming uninsured as a result.
It's not that simple. Just go out and get yourself some insurance. Uh, while the Senate Finance Committee proposal has made some cuts deeper, as I said before than the house pass Bill, both are certain to lead to more hospital closers and reduce access to care for rural residents.
And of course we know this. Also, it hits hard on, economic hardship in communities where hospitals are the major employers. So as for the so-called, Rural Hospital Stabilization Fund, I've had some conversations about this. In the report that I received, the Senate has seemingly acknowledged the damage and floated this idea.
But the fact is that the 25 billion that's being proposed will not even scratch the surface of the long-term damage. In one analysis, the $25 billion fund falls so far short of what is needed, even if every single dollar of the new fund went exclusively to hospitals, which I have no reason to believe that they would, it would not fill even half of the gap in funding for rural hospitals created by the OBBB bill.
So more specifically, this bill generates 58 billion in Medicaid cuts over the next 10 years. That a decade of pain for rural hospitals. But the Rural Transformation Fund is limited to $25 billion over this time period, which is only 43% of previous funding levels. Again, if all that funding were just to go to rural hospitals, so it doesn't cut it.
Now shifting over to SNAP really quickly, which is of course the Supplemental Nutrition Assistance Program administered by the USDA. The Senate version of the Bill retains onerous work requirements for SNAP recipients. Um, in this disproportionately, we know this affects rural residents because of course, many rural areas lack reliable transportation.
Childcare is woefully absent in many, most rural communities and employment opportunities look very different than those in suburban and rural areas. As I said before, kind of an interesting side note is that rural hospitals are usually the largest or one of the top three employers in a rural community.
So when they close their doors because of this bill, watch rural unemployment numbers. Uh, keep your eye on that because there are layers and layers of consequences, and I would say at this point, intended consequences.
On the education front, there are more than 9 million students, by my account in the US attending rural schools. And in some states, the numbers are over 60% of the student body population attend rural or small-town schools. You'll not be surprised to learn that the Senate bill also reduces federal support for rural education. In fact, calls for significant cuts to Title One funding, which supports schools with high percentages of low income students and potential rollbacks of funding for rural school, transportation and broadband access programs, connecting the dots.
That's what we do here. In previous episodes, you know, I've said, “Hey, don't believe me. Just look at the numbers and the math facts.” These are important because despite what you may be hearing in the news, when, and this disturbs me greatly when a Republican senator says, “Hey, we're not cutting Medicaid.”
The fact is hey are, and that is their intent. It's written right on the pages of that bill. There is no talking your way out of that. In conclusion, the One Big, Beautiful Bill Act does not support rural America, not by my estimation, again, not by many others estimation either. From healthcare to education, from agriculture, to provisions that provide permanent tax cuts for wealthy.
And as I'm going to paint this image for you, kind of a dental floss as a lifeline for the rest of us. It is important to know that rural communities are being told that they must sacrifice their long-term wellbeing for short-term tax breaks. That's what it amounts to. That mostly benefit the wealthy and large corporations.
If only the wealthy and large corporations were standing up and saying no to this bill. But there are crickets where that is concerned. Because all roads lead to the quality of life are paved by policy. Lemme say it again. All roads to the quality of life as we are seeing right before us are paved by policy.
Then as a citizen, I wonder if you agree. It's time to make sure that policy makers understand that this bill is dangerous, it's harmful, and if it does or if it has already become law, rural Americans will suffer and the next generation will bear the brunt of that pain. They will pay a heavy price for the actions taken by us today or not taken by us today.
Friends, I say it often, these are not like subjects, and I know that in my heart, I do hope that something that you've heard here today has been enlightening to you. All of the resources mentioned here today, including the data that I've shared with you will make sure that we've got it on our website.
Again, the ruralimpact.com. We would be so grateful if you would join us by simply subscribing it takes literally seconds to do so. And that way you'll make sure that you get our updates in your inbox and, get some previews of future episodes. And we have many of them planned for you. It helps us to keep, these conversations going if you would consider making a donation.
We do appreciate that. And listen, if you are interested in a partnership to better understand how we can help you expand your rural reach, just reach out to us and we'll be happy to share those details with you. For now, and as we sign off, as I always ask you to do, please take good care of yourself and to the best of your ability, all those around you.
Many of our rural America partners, our neighbors, our friends and family are suffering today, and it's important that we extend ourselves as much as we can to make sure that we are taking care of our own communities. Thank you again for joining me. Again, I'm Michelle Rathman and we are going to see you on a brand new episode really soon of the Rural Impact.
