64. A Conversation about Rural Prosperity and its Connection to Policies, Past, Present & Future with Tony Pipa, Brent Orrell and Matthew Hildreth
Michelle Rathman: Hello, one and all and welcome back to another episode of The Rural Impact. I'm Michelle Rathman, and I mean it when I say I really sincerely mean it, thank you for joining us for another conversation that works to connect those dots between policy and rural everything.
Today, full disclosure, we have a jam-packed episode, I mean, packed because, as the title says, our focus is on rural prosperity and its connection to policies past, present, and future.
Since the last time we were together, you know, I don't have to tell you this, you know this, there have been round the clock conversations and convenings of rural stakeholders who are really working to understand how to manage and move forward with massive policy and funding shifts that across the board and by many accounts just darn bad for rural.
But at the same time, this is happening, rural serving organizations well, they continue to do critical work that's intended to strengthen rural economies, devise solutions that address this country's increasing and worsening rural health challenges, as well as address strains on natural resources and navigating, many environmental disruptions as well as building that all important civic engagement places where both participation and representation is shrinking, along with investments and resources.
Now, for this conversation, I am elated to share with you that a old friend of this podcast, Mr. Tony Pipa, Senior Fellow at the Center for Sustainable Development at Brookings, joined us. And with Tony we were also joined by Brent Orrell, and Brent is a Senior Fellow with the American Enterprise Institute, and that's just part one of the conversation because after you hear from them, we're gonna take a quick break where you can hear from our new partners at the National Association of Rural Health Clinics.
I got an exciting event to talk to you about there. And then after you hear from about our new partners, I was joined by Matt Hildreth and Matt is the Executive Director of Rural Organizing. This is really interesting because Matt literally joined me on the road while he was on location at the 2050 Fest in Pennsylvania.
I had no idea this event existed, but I sure am glad that I do now because this is, and this is a quote from their website 'where the next generation of rural leaders come together to build community and share bold ideas for the future.' I cannot wait for you to hear my conversation with Matt. So, like I said, it's a jam-packed lineup today.
With that, I invite you as always to tune out that background noise. You might wanna get yourself something to stay hydrated, and let's just get started. Let's go.
Michelle Rathman: Tony Pipa, Senior Fellow at the Center for Sustainable Development, Brookings Institution. Welcome back. It's great to have you here today.
Tony Pipa: It is great to be here. Thanks for having us, Michelle.
Michelle Rathman: It's great. And Brent Orrell, it's the first time here with us at the Rural Impact, Senior Fellow American Enterprise Institute. Again, welcome. We're really grateful that both of you can be here to have this conversation today.
Brent Orrell: It's an honor. Thank you.
Michelle Rathman: We are in some interesting times I should say. And so what you, the work that you're doing together, I think is incredibly timely and I'm looking forward to having you explain to our listeners what exactly it is that you're up to. So Tony, in March of this year, Brookings and AEI established the commission on us real prosperity. It goes on to say like the mission here, “developing a national rural strategy and reimagining rural policy for the 21st century.” That's a big undertaking. So, start off, what is the commission on US rural prosperity? What's the mission? What's the why behind it?
Tony Pipa: So this is a partnership between the Brookings Institution and the American Enterprise Institute. Brent and I are, are leading this for, from the perspective, of our institutions. It is a commission in which we're bringing leaders, former elected officials, leaders from all different segments of American society, together to understand what's happening in rural communities across the country. Think about how do we ensure rural places thrive over the next 20, 30, 40 years. So, we're taking a long-term approach. We know how important rural communities are to the health of our country and the interdependencies that there are between rural places and other places.
And so, we wanna take a look at how well is federal policy supporting these places to help them be resilient, have economic opportunity, look to the future and be able to adapt to any changes that are happening economically, socially, or otherwise.
The commission will be co-chaired by a former senator from North Dakota, Heidi Heitkamp, and former governor of New Hampshire, Chris Sununu and we're putting together a roster of people who, some of whom know rural well, they've, you know, they've served in capacities where they've been serving rural places or just because of their business or otherwise, have some have some familiarity. Others we think actually are in places that are really important to rural but maybe aren't looking at rural or seeing things through a rural lens.
And so we want to have a mix of both of those. And just let me finish by saying to your point what we will hope to do over the next two years is one, we're going to visit rural places. We want to hear from rural people what's happening in their communities. What their aspirations are for the future and the extent to which they think policy is working well or not on their behalf. And then we'll produce at the very least a final report, what we're calling a national rural strategy. It'll have recommendations in it, primarily focused, I think on the federal government, but potentially states, local governments maybe philanthropy, other investors as well.
Michelle Rathman: Like I said, I mean, it is a tremendous undertaking, and I have so many questions I wanna ask you. Brent, I wanna just kind of flip to you for a moment because I know the work that Tony has been doing on reimagining rural for a long time, but if you could just familiarize our listeners to why AEI partnered with Brookings Institute on this rural agenda. What's the, what's the motivation there?
Brent Orrell: Sure. I mean, I don't think it's missed or escaped anybody's attention in the last 10 years that the gap between metropolitan and non-metropolitan or rural America has really turned into a chasm and a number of dimensions. You know, socially, culturally, economically. 75% of the US GDP, comes out of a handful of cities.
Rural communities are declining in terms of their population for the first time, really almost in history. And, in terms, in absolute terms that rural population is getting smaller. And, and that has huge ramifications for the country. And I think that, you know, as Tony, you know, was talking about interdependence.
We actually, when we rolled out the commission just before the 4th of July, we toyed with the idea of calling it interdependence day. Because, America is not two countries. America is one country, and rural communities and urban communities need one another to thrive. We draw a tremendous, not just, I mean, we draw a tremendous amount out of our rural communities in terms of resources tangible resources, but we also draw a tremendous amount of our identity as a country out of rural America.
And, and it, and it permeates, the ideas of rural America in terms of the independence of the individual. The frontier mentality of we can do this, we can create, out of the raw materials that we have as a nation a future. I mean, this is fundamental to who we are and this, and this failure to adequately pursue that idea of one America I think has really gotten us into a ditch.
And we need some new thinking about this. How do we capitalize on, the best of all of all of America to continue to help the country to grow and thrive. And so that's, you know, we are the American Enterprise Institute.
You know, this is, this is vital, this is a vital question. We've had an American Dream Initiative that's we've had for the last, for the last couple of years, which has been focused on extending the promise of American prosperity, two non-metropolitan areas. So, this really came at a, at a very good time, in the life of, in the life of AEI.
Michelle Rathman: Thank you for that. You know, as I look at, I've read the research agenda and there are these research pillars that you have, and everyone who listens to this podcast knows we work to connect the dots between policy and exactly all the things that you all have put into this mix, if you will. And so let's, Brent, I'll stay with you for a moment.
'Cause the first research pillar, and again, all of this so incredibly relevant as we record this on the seventh day of August. The first one is economic and workforce transformation and the age of AI and automation. You know, I wish we were talking about this, you know, decades ago when we saw it coming, but you know, I just feel like we have a lot, you said ditch.
We have a lot of catching up to do with this is concerned.
Brent Orrell: Yeah.
Michelle Rathman: There's just such a, a lack of understanding and, and we talk about in healthcare, you have to embrace it, and yet you either, most of people I'm talking to right now are kind of running away, not leaning in. So, let's talk about that in the context of economic and workforce transformation. Talk to me about what's inside that pillar, if you will.
Brent Orrell: Yeah, I mean, I think you hit it exactly on the head. We as a country have really just come through one of the most abrupt chapters of automation that the country has ever experienced. I mean, in terms of the short period of time, relatively speaking, from the mid to late 1980s through the early two thousands is really short.
I mean, that's a short period of time in the scale of the nation's history. And for human beings who really don't change very much and have challenges adapting to rapid change. So, we just came through this really abrupt change that disproportionately affected non-metropolitan America.
We think of manufacturing as being something that happens in cities, and that is just not true, and it's, it hasn't been true for a long time. Manufacturing in this country was primarily small towns. And rural areas that provided the manufacturing base of the United States. Therefore when we had a lot of disemployment, robot moved in, we had a lot of dislocation, and that dislocation felt mainly on communities outside of our, out of our major, outside of our major metro areas.
We have another huge wave of automation coming. It's gonna be different than the last time. It's mainly a function of people working in the knowledge economy rather than in manufacturing. At the same time, so that means that it'll be a different kind of population that gets hit first and hardest, I think, in this round of automation.
But people living in rural areas have a different kind of risk, I think, on with, with the emergence of AI, and that's the risk of falling further behind technologically. So we have a huge task, you know, you know, we've been working on broadband for decades and we still haven't gotten it into rural areas the way it needs to be.
AI is just gonna amp that up quite a bit. And the risk for rural communities in this is twofold. One, they will become the home of a lot of these data centers and that's gonna have huge economic impacts and environmental impacts in rural communities. That's something we have to be concerned about, but the han capital side of this is just as important.
If we don't, if we don't all, and this is everybody, not just people in rural areas, if we don't get into this technology and become fluent with it and welcome it as a partner, the risk of falling behind becomes incredibly profound.
The, for the workforce of the future, there are three things that are needed, fluency with artificial intelligence, good basic, technical skills, mathematics and reading and so on, and then a quality of judgment that's needed to, that will be needed to assess the massive amounts of information and analysis, that AI is going to produce.
For two of those things. We really have to make friends with AI and I'm concerned that rural America will slip further behind because it'll be the last of the, of Americans who pick this tool up and start using it.
Michelle Rathman: Which is really ironic when you think about it, be because as you said, I mean, what it, what's required? Will require rural to be a major participant. And my concern always is, is that does it become like a dependency or an opportunity? And there's, where's the ownership there, you know, where are there opportunities to grow their local economies as a result of embracing this?
Which is, the next pillar that you have and, and Tony, I'll throw this over to you because the next one that, that I'm seeing on here, is it, is that right? Is it the demographics, quality of life and infrastructure? So, for the workforce and the economic development thing, these, these are all connected. So, let's go through that pillar and talk about the major the key points within that.
Tony Pipa: Well, well, let me just build on a couple of points that, that Brent said before I even go into that. And that is, one that while there's a risk of being further left behind, to your point Michelle, there's also an opportunity here. So, you just mentioned infrastructure being the part of the next pillar. If we have the infrastructure, both the physical as well as the civic, AI could be a boon on both business dynamism, business startup, as well as new types of employment in rural places.
But we've gotta have the infrastructure, we've gotta have the educational and the human capital infrastructure, the kind of training programs and or educational programs that enable that. And we have to have the physical infrastructure, right?
We do need to get broadband and other things actually into those places. The second thing I would say, and Brent mentioned the data centers. From an economic development point of view, it almost looks like a gold rush right now. But that rush is coming from the outside, right? That rush is coming from states that wanna benefit, from the companies that are leading the revolution because they need, they need the computing power, but it comes along with that computing power and Brent referred to this is, you know, electrical usage.
It's gonna take a lot of land, water usage. I mean, not too many people are thinking about that from the point of view of the local communities themselves. How do they make sure that they're at least a partner or in the driver's seat of how you manage these resources and where the economic benefits go from that? And again, that comes back to infrastructure as well. But it is also going to be, you know, demographics is really important in rural America. You know, we've seen declining population. Some of that's just even, about replacement, you know, more deaths than births. You do have people who will, especially for educational opportunities, migrate from rural America and then not always return. Right. And, I think what we're seeing from an economic development point of view, what we've seen emerge over the last 10 or 15 years is that the distinctiveness of rural communities, both, sometimes it's their history or the identity as a town. Sometimes it's just the way in which communities work.
And, Brent even mentioned how important rural is to our cultural thinking in the U.S. Rural places have a lot to offer for say, a young family, right? And if you can have the amenities and the equality of life, if you can have childcare, if you can have elder care, if you can have the support that's necessary and make places an attractive place to live, we're seeing that as actually a really important part of the way in which rural places that are doing well.
That's a basis for how they thrive. And they're welcoming, they're welcoming to newcomers. Now, from a cultural perspective, there's a stereotype of rural places being closed off and frankly, in small places, to have people come in from the outside is frankly more disruptive. It's, it's a bigger change, right? But we have seen in addition to the focus on quality of life, places that are welcoming to those new people, see new business, see new types of just kind of renewal of their civic structures, and see new dynamism going forward. See, see kind of a, a, a dynamic hope for the future rather than a, “huh how are we gonna deal with all this change?'
Brent Orrell: So, Tony made a, a really important point there. Because it's a commission on policy. Policy is about solving problems. Right. And there are significant problems. But in our, you know, our preliminary research on this, some of the most, dynamic and sort of socially and economically well off places in this country are rural areas that have retained their rural character while adapting to contemporary life.
That's a story that needs to be told too. So we're gonna be focusing on challenges and problems and what do we do about all of these different things, but we also want to make sure that we lift up the success stories of rural America cause they are significant.
Some of the, some rural areas, if you're looking for socioeconomic mobility, many rural areas are some of the best places in America to live.
Michelle Rathman: And, and as I'm, as I'm looking at something that came out of the research that you sent me, 85% of persistently poor counties are rural, which are nearly half of the aggregate population, identifying as a racial or ethnic minority. I mean, that's a pretty, I agree with you to lift up those stories and to be able to provide a roadmap. But the policy, I love what you said, that policy is meant to solve problems. I think at the same time, we've got a lot of policy right now that's creating wreaking a lot of havoc for rural, and I would be remiss if I didn't say it because so much of what you have in this really amazing agenda and the research pillars and whatnot, policy can also stand in the way.
I mean, policy can open up the doors for opportunity or it could stand in the way and put up a whole lot of roadblocks. Let's move on to the next one because this, this is Brent and both of you, the natural resources, climate change and resilience. We've gotta be able to say the words out loud and we've gotta be able to be completely transparent that this is going to be a challenge for rural, probably a lot faster than folks even want to imagine.
You talk about the AI, you know, just kinda hitting us in the back of the head so quickly, like that slinky, I think about that image in my head that like barrels down the stairs. I'm really concerned. And I think many people are out there and there's just a lot happening right now. And we say the word climate change and resilience and natural resources. What are you hoping to achieve, under this particular research pillar?
Because we have to work on this fast.
Brent Orrell: That, you know, climate change is controversial at the national level. You know, the degree to which it's happening, how much of it's, is happening and the sort of the aggregate numbers, are contested, you know.
At the local level, particularly in rural areas right now, I don't think there's as much disagreement that something is happening, right? We have seen you know, in the Carolinas just recently in Texas, kind of extreme events. You know, we talk about them as once in a century kind of storms, and now they're once a year kind of storms that we're experiencing. Now, I think we have to be careful about overshooting on climate change because I think that as with every, every policy questions, there are trade-offs that if you push too hard on one side, you're gonna create consequences elsewhere that you can't really imagine.
We don't, for instance, we can't, the only way we're going to have the resources to adapt to climate change is if we have a vibrant economy. And if we clamp down on carbon emissions so much that we slow the rate of economic growth, say that makes it that much harder to find the resources to adapt to climate change.
We can't really stop it entirely. And we're going to need to be adaptive when it comes to climate. And that's really, I think where the focus needs to be for us in this commission is like, how are we equipping rural areas to survive this right? And to thrive in spite of it. And, so that's what I'm hoping when we're, as we're delving into this, what are the actual, we can find out what are the actual needs, what can, what's the role of the federal government in mitigating this? And, at the same time, not lose sight of the longer term challenges that we face in terms of restoring the economic vibrancy of rural America.
Tony Pipa: And Brent makes a really good point about just the uptick and the increase in severity and the amount of these things happening. And the way in which our federal policy and our system is set up right now is to come in after the fact.
Right? Like to provide a lot of investment after the fact. And I think, a lot of people across the aisle have seen that we're not performing very well in kind of the structures that we've even set up to do that. In fact, you know, just on our podcast, we just had a couple of episodes about the situation in Western North Carolina after Hurricane Helene. The recovery, you know, the pitfalls and the, the strengths and weaknesses of working with FEMA and other agencies.
And certainly, this administration's put a bright, bright spotlight on that. But I think we also have the opportunity, and to Brent's point, he just mentioned the word adaptation several times. Like we have to start thinking also about what are the investments we need to make upfront so that communities are more resilient from the very beginning as well.
And our policy has actually not been very robust around that at all. Right? We're not creating incentives for local communities to take new things. In rural communities, they don't have a lot of capacity. It's not like we've got a lot of people in local governments, in rural communities that that's their job to be thinking about. Right?
So, I think there's a huge opportunity here. A huge, there's a lot of room, I think, for new thinking, and I even have some colleagues at Brookings that have been, you know, doing some writing. I know Brent's got some colleagues at AEI. There's a real opportunity here, and frankly, it is an urgent issue, Michelle.
I mean, I I'm glad that you, you brought it up because there is an urgency here. We're doing some research just looking at the extent to which rural communities are part of Stafford Act Declarations, and they're, they're in the majority, right? Like this is, this is a big issue.
Brent Orrell: I just to, surface a point that I think really fits in here which is, I, I'm afraid it, it's mostly on the Republican side here that we're not, that we're not seeing the kind of responsiveness to the local impacts of climate change that we need to see. Right? You know, conservatives are, you know much and you can hear it in some of the things that I'm saying.
Were much more, you know, thinking about kind of the trade-offs involved here, as a baseline. And then you've got, you know, a kind of political, atmosphere, culture, ecosphere, or whatever you want to call it, that is not paying attention to what is actually happening to rural America, when it comes to climate.
Those are those states, those areas of the country are heavily Republican and it's an example of the inadequate kind of, I think of the inadequate response of the Republican party to its own constituencies.
so, it's, it's paradox.
Michelle Rathman: Yes Thank you for, for sharing that. And the, the, the one thing I wanna make sure, another pillar I wanna talk about for sure, I have a personal interest in this. All of us should, and I don't mean to should on people, but I just said it, health outcomes and delivery.
You know, yesterday I just sat on another hour long constituency call, grassroots constituency call, about the impact of H.R.1 and on health rural health. I don't think folks really understand yet, and I, I talk to people who say, oh, I don't know. I don't know about that. And I think that's something where in this agenda, it all looks great on paper, but we are now literally at a point where rural health is being ripped apart and we have to adapt.
That was a word that came up yesterday. Like now, because it's done, the deal is done. We've got this real transformation fund and so forth. There's, there's a lot of things it is and a lot of things it isn't.
So let's go there. Tony. Let's talk about the health outcomes and delivery, the research.
Tony Pipa: Well first off, the health outcomes, it's just really important, right? I mean, we were talking about demographics a little earlier. You know, is, also that when you just look comparatively health from rural areas to suburbs and, and urban areas, there's a lot of indicators that are much lower in rural places.
And so we need to create an environment in which people. Have access to the health services they need. And we need to be both creating the economic opportunity, but also the infrastructure for people to be healthy, for wellness, to be something. And it comes back to even some of the things that I also mentioned earlier on.
It's not just about health services directly delivery, but early childhood education through elder care. Right? It's like the whole, it's the whole continuum. The corollary to that is, and I don't think we talk as enough about this, and partly it's because many times when we say rural, even policy makers in Washington or a lot of decision makers always think AG when they think rural.
Michelle Rathman: Right.
Tony Pipa: The health economy in rural is extremely important. I mean, and it's an anchor economy now. It's one of the largest employers and economic engines in many rural places. And to your point, given the changes that have been passed, that will be coming in terms of you know, the health policy, the federal health policy around, Medicaid, and even the nutrition programs. You know, rural health infrastructure, rural hospitals, rural health clinics, health providers are going to have to adapt. And it does, there is, there was already risk to that health infrastructure, and the economic health of the, of that health infrastructure. And so it is something that we're going to have to grapple with.
And, it's not, it, it's both as you're saying, an issue at the individual in the household level. But it's also an issue at the economic development and community and civic infrastructure level. Now, let me just insert one thing that we haven't talked too much about, and I didn't even touch too much on, you know, when I introduced the commission, and Brett was even just talking a conservative point of view, you know, when we were talking about natural resources and climate change.
I do think one of the things that often happens, especially when we talk about rural places, is that we get skip bought up in politics right away rather than talking about the policy and frankly, the polarization and kind of the polarized political environment really exacerbates that, right? People go to their corners right away. Brent and I are determined that we kind of have these conversations across the aisle. We just put these issues on the table and try to be straightforward about where there's areas of agreement and disagreement, but hash it out. I mean, this is a nonpartisan, bipartisan, cross partisan, whatever you want to call it. We just think it's really important that we get to the policy solutions around that and that it's really informed by people in their communities. I think one of the reasons why we've had that partisanship is that some people feel like they haven't been a big part of the policy decision making process, and that their interests haven't been protected or, you know, or taken into account in that extent.
Rural healthcare, I think is one of the issues that, you know, is really gonna test us on this because it is so important and and, and because it's, it's gonna be going through change. The other thing I guess I just would add though is, you know, we are gonna be taking a longer term look at this, so we're gonna have to take, this is present day, this is where things are at.
What can we suggest that will, ensure that rural places are positioned as positively as possible to actually really thrive both with their health outcomes, but also with the infrastructure that they're gonna need to be able to be healthy and, and achieve those levels of well-being?
Brent Orrell: So I want to dwell just for a second on the health outcomes. 'Cause this has been the bee that has been particularly in my bonnet, around how we think about health in rural areas. We tend to go immediately to, because it's so important as Tony articulated so well, you know, these are economic drivers.
Healthcare is economic driver. It's critical to, the capacity to attract people to live in rural areas. I mean, you can't, you know, who wants to drive five hours to see a cardiologist? I mean, that kind of, there are, there are all sorts of reasons why it's so important. One of the reasons it's so important that I don't think gets enough attention is that from a workforce standpoint the health of human beings is fundamental to the ability to attract and retain economic opportunity. If too many people in a rural community are struggling with obesity, are struggling with high blood pressure, are struggling with joint disease, are struggling with kidney failure, are struggling with
Michelle Rathman: addiction
Brent Orrell: you know, caring for relatives with Alzheimer's, all that stuff is all downstream from inadequate healthcare early on and inadequate maintenance of health through the lifecycle. Those issues demand a lot more attention than they're get, than, than, than they are getting, and it's a tragedy.
Because no matter how much, how many resources we pump into rural America to try to restore the economy, if we don't have healthy people who can work, who can stand for more than 15 minutes, then the options are very, very limited. You know, in terms of the dynamism, long-term for that, for that community.
And yet when you go to rural Americas, you see, you know, you see the problems. They're, they're quite obvious when you go to rural America what the challenges are disproportionately in those communities, especially in terms of obesity. Hate to say it, but that's a really big problem, and it's driving. Like I said, it's the headwater condition that is driving so many of the bad out outcomes.
We've gotta get serious about that. It's one of the few things I've ever agreed with Elon Musk on, is that, you know, getting the right tools into local communities to help with that issue is probably, one of the most important steps.
Michelle Rathman: I a thousand percent agree, and it's not gonna happen with more food deserts. It's not gonna happen, you know, with these nutrition programs. And I'm just gonna plant, like, when you guys are on the road and you're doing this work, take me with you, I'll be your, your roadie. But something I've been thinking about because of the work that I do with rural hospitals. You know, there's a lot of, you know, as you said, manufacturing that's happening out in rural. I believe there should be a mandate if you can do this. Any major organization that wants to go into a rural community, they have to invest in their local health infrastructure.
It doesn't happen. I've seen it. I've seen the timber industry, you know, fight to pay and they, the, the rural tourism people come in. I work in places where tourism is a big deal. 300,000 people come in. They don't receive a, the hospital doesn't receive a dime from that, the, from taxes or anything like that. And so I think if you're, when you're talking to folks, when manufacturers wanna go in and they wanna bring in these AI infrastructure that they should put something towards local healthcare.
That's my, that's my soapbox. Okay. Couple more things I wanna make sure I talk to you about is the governance, policy, coordination, and federal investments. Seems like that's the biggest lasso maybe of all that we have to take a look at. So, talk to me a little bit about that.
And on the other side I wanna talk to you about, , what we all can do to help you support this work and, and our advocacy work. Bipartisan, you know advocacy.
Brent Orrell: I'm gonna let, I'm gonna let Tony kick off on this governance thing
Michelle Rathman: Let's go. Tony,
Brent Orrell: yeah, he's got a great
Michelle Rathman: your spaghetti chart I know
Tony Pipa: Yes,
Michelle Rathman: I call it a hot mess. The first time I met him.
Tony Pipa: Well, Michelle, as you know, some of the research that we've done is to landscape the federal resources that are available for local communities, for their community economic development. You know, we weren't even, well, we did that chart. We weren't even looking at sort of the programs that were focused on individuals and households means tested programs.
We were, we weren't looking at the nutrition programs or even Medicaid, Medicare, for example. We were looking at investment for sort of the economic future or the infrastructure, both social and physical that would be necessary for community to thrive and, and be well. And you know, in rural places, public funding is exceptionally important. It is a place where the market doesn't always react or want to invest because of distance or because of scale and those sorts of things.
And so rural places are a place where the capital stack, quote unquote, if you will, is often a real interesting mix of public funds, whether they're federal and state, private, you know, whether it's loans or whatever, banking, other kinds of financial investments, and then sometimes even philanthropic. The federal landscape and the federal system ecosystem, if you will for that type of investment is very convoluted, very complicated.
So it's a positive thing in, in one way, in that, you know, Congress was always responding to a felt need when they created a new program or they created a new mechanism, they had constituents, say, “Hey, this is something that we need. We're not being able to get this kind of investment.”
But over time what's happened is it's just become very hard to navigate, and it's a double whammy for rural places because they don't have a lot of people in their local governments or local nonprofits that can spend the time and have a lot of extra bandwidth to be able to identify what matches their needs and what they might wanna access and take advantage of. And there's a whole host of other things like match requirements and reporting requirements that make it a lot more difficult for them as well.
Michelle Rathman: Mm-hmm.
Tony Pipa: I'll also say, though, on the other side of this is that I think one of the things we've really experienced as we've been doing the work on rural policy is that local governments in non-metropolitan places, whether they be county or local, jurisdictional or municipal, really do have significant limits on their capacity right now, and they're very constrained in terms of financial resources, their tax bases are, are sort of pressed to the limit and in terms of people, and so they don't have, they are really focused at this point, like on kind of a Maslow's Hierarchy of Needs.
What do we need to do just to be able to deliver the services that we're being asked to be responsible for? And those services continue to sort of expand, right? Without a huge expansion in the capacity to do it. And so, I think we're gonna have to grapple with that too. What's the federal role? What's the state role? How do we make local governments whole and capable? Maybe there's some technology there that can help, but I think there's also ways that we have to think about the fiscal health of these places as well.
And be very careful though, you know, because for example, when you think about on the educational system, then you say, okay, well, we'll consolidate 'cause we'll have economies of scale. But if you don't, if you don't share things in a way that retains the identity and the agency of those local places, you lose an enormous amount as well. And so, I think this is something that we are going to have to , we're gonna have to grapple with and and, be cognizant of we're, after they're gonna be thinking about the federal role, how do we make that more effective, more efficient? From what it's offering, but then also how it relates to states and and local governments.
Brent Orrell: So I just have a, a couple things that I wanted to add on to that. The first, first of all, I think we need to be realists about this, right? , I, one of our first meetings that we had, that we've had around this effort was to draw in a bunch of people who knew kind of, the history of federal intervention in rural communities, which of course goes back 150 years, you know?
And one of the things that struck me out of those conversations, just how consistent the challenges are. You know, this is nothing that we're dealing with, with the possible exception of like the opioid crisis is new, right? The migration of people who used to live in rural areas into urban areas, that's been a trend for a couple hundred years, or a hundred, at least 150 years.
And we're probably not going to reverse that through a, through policy. We see a little bit of, we saw a little bit of it during the pandemic where the virtues of living in rural areas became more apparent to people. And we saw some, some, I don't know how statistically important it was, but at least anecdotally we were seeing some return to rural areas.
So, maybe that will continue. We don't know. But the problems that rural areas, experience, there's not a lot new under the sun, you know? And so, we need to have some humility as we approach this. You know, what, what are the kinds of outcomes that we can reasonably hope to achieve given these, these very long-term patterns and trends, that we're grappling with?
I guess that's what it means to be a conservative, right? Like, we take the world as it is, you know, we don't want to, we're we're anti-revolutionary, at least we used to be. And, we take the world as it is and we try to work with it as it is. And so, that historical perspective is gonna be very important.
And this is the last thing I'll say about it. One of the guys who's gonna be helping us, helping me with this in particular, is a gentleman by the name of John Price. Who is now in his eighties but who worked in the Nixon White House in the 1970s when the last big push on rural policy happened.
It's been that long since we've really had an in-depth look at rural policy. He's going to bring, help us bring that historical perspective because as he pointed out in our conversation, you know, we really looked at a lot of different options, and, and you're gonna be looking at mostly the same options as you try to address these policy challenges.
So the problems are largely the same. The range of solutions is going to be largely the same. And so it's really a question of, you know, what we can do to maximize the opportunities that we have rather than fall victim to nostalgia, which I think is a constant problem for all of us all the time is we're trying to restore something.
You can't restore it. You can only work with it as it is and try to create the new, so I just wanted to add that.
Tony Pipa: Michelle, let me add onto that just as, because as Brent was talking about John Roy Price and, and the Nixon administration, when I released the original report that helped shape the work that we're doing in the Re-Imagining Rural Policy Initiative, I had a couple of people actually send me a letter that Nixon had wrote to Congress about the revenue sharing proposal that he had for rural places and said, do you realize that one of your recommendations looks very close to this? And it is. There, there is a little bit of to Brent's point the issues are, you know, they're connected to the 21st century in different ways, but the elements themselves, there's a lot of familiarity with history and, you know.
I also think one of the things that's a big challenge and for any economic thinking is, you know, we're not just necessarily gonna grow every rural place into a small city, right? It's how do we enable places to thrive or even shrink and continue to thrive in some way? And what's the, what's the palette and, you know, what's the toolbox for being able to do that?
Aand not every place is also going to, you know, potentially adapt, ,
Brent Orrell: We, even if they can't adapt, we still have to care about
Michelle Rathman: Right. I mean, that's a thing. I mean, we, we throw this word
around, you know, thriving a lot and I agree, and that requires that sustain that. You only thrive when you sustain.
I mean, and right now it just feels, you know, and I am, I tell folks, I'm a really optimistic individual. I've been doing, I've been in in rural health and urban health before that for over 30 years, and I am stunned at how far we have not come. And that it stuns me, to be honest with you.
Cause we know, we know we have so many of those answers. I say often we have the, the, we have the way, what we lack in so many areas is the will.
Before I let you both go, and I, we could go on forever. I think this is great work and I'm glad that we are able to have this conversation and this, this candid conversation.
So, knowing that right now rural policy landscape on the federal level is quite uncertain, we don't know what the future holds. None of us do. Although I can on this path, I can only. Unfortunately, imagine what might happen if we continue to divest in rural health and infrastructure and broadband and so forth.
What can our listeners, what can you offer our listeners? And we've got a broad base of listeners in terms of the role that they can play in reimagining rural policy where they actually have agency where they do have control. So maybe for each of you, just a few secondsa soundbite, if you will, of what your recommendations will be for those who are listening.
Brent Orrell: I will go. I think it is so important that we don't get overwhelmed by and surrender to the problems. Right. And if you just stare at the challenges it, it will overwhelm you. And it'll, you know, you throw up your hands and you know, and you give up. And I, and we, that's as unrealistic as saying that we're going to create nirvana.
You know, we can't, we can't have that. I think you know, the average person, they're not, you know, an elected official. They're not they're not working in policy issues, is to get engaged in your community. Get engaged, find something. It doesn't have to be big. Volunteer for the library board. Go. Just be engaged.
Be part of the connective tissue that holds communities together. This isn't just a rural issue, this is an issue in communities across the country of all sizes. But that's where you can create the critical mass necessary to start building a more positive future, , rather than falling into despair because you're, you know, you're so aware of the problems that you don't have any energy left to to contribute to the solutions.
Michelle Rathman: the great advice. Tony, what about you.
Tony Pipa:I mean, I can only reemphasize what Brent just said about getting involved because I will say that, both from the analytical work that we've been doing as well as the qualitative work that we've been doing through the podcast and other that is a through line for rural places that are sustaining themselves, as you say, Michelle, or even thriving, like even improving and going beyond. That type of civic involvement and many different people just coming together and being determined to love their place and solve problems together has been a through line that that is just a recurring theme.
I would also say that look, you know, the Brookings Institution and the American Enterprise Institute are well known in Washington DC. We're able to be able to engage policy makers, congressional or in the executive branch. But we also want to ensure that we're really both well informed by the reality that's happening across the country. And so we're gonna want to hear from people. So if we're coming to where you are and we're asking for input, we would want your participation. And I would also say, look, use the attention that we're trying to bring to these issues.
Use, you know, we're going to try to ensure the media is talking about these issues. Right. We're gonna, when we come to a local place, we're gonna try to get the local media involved in bringing some attention around it.
Look for ways to use that, take our articles and or whatever we're putting out and use it on behalf of the good ideas and the solutions that you're creating in your local communities as well.
Michelle Rathman: I think what's, you bring up a really important point about, you know, local media and whatnot, and I, I teach a course on, you know, misinformation and social media and so forth. I think this is another area that we really have to look at because we have news deserts and you know, we have a lack of curiosity in some respect, but.
When, when your feed is filled with everything that affirms, whatever it is you believe, we have to be able to, to talk about it, but to disseminate this information to in the hands of influencers is what I'll say. So, I love the idea of the civic engagement. We need influencers to sit around and have those conversations. Might be, not political, but a courageous conversation about the direction we want our community to go and how we're gonna will it that way.
My gosh, Brent and Tony, I really would love to have you come back when you've got some updates for us andertainly we'll be looking for that, that end result in 2027, which seems so far away, but the way things are going, might as well just be tomorrow. So again, thank you Tony. Always great to see you, Brent. Great to meet you and have you. as a friend of the Rural Impact.
Tony Pipa: Thanks for having us, Michelle.
Michelle Rathman: Oh my gosh. Okay. Even though we're gonna bid Brent and Tony Farewell. For now, the rest of you have to stay put because we have got an important announcement to make from our new partner, the National Association of Rural Health Clinics.
And after that, my conversation with Matt Hildreth, the Executive Director of Rural Organizing, it is a big show day. We'll be right back.
Interview with Matthew Hildreth
Michelle Rathman: Hey, we're back and it is my pleasure now to welcome to The Rural Impact Matt Hildreth. And Matt is the Executive Director of Rural Organizing. It's great to have you here for this conversation. Welcome.
Matthew Hildreth: Yeah. Thank you for having me. I'm glad to be on.
Michelle Rathman: Thank you so much. And you're on. You're on the road. You know. So, Matt, first, because I think everyone needs to know what your organization does, but talk to us just really quickly give us an overview of Rural Organizing.
What is the mission?
Matthew Hildreth: Yep. Rural Organizing is a national network. We have, people in every congressional district across the country, and we're really focused on empowering rural leaders to have a seat at policy making tables. So we're all about rural solutions to rural problems and empowering especially the next generation of leaders to take that, take on those challenges.
Michelle Rathman: Yeah, it's a, it's a great mission and I like that you said the next generation of leaders, 'cause we have a lot of conversation on this podcast about building civic muscle and so, so very important. So, the first half of the episode, our listeners heard a conversation that I had with Tony Pipa from Brookings Institution, and Brent Orrell excuse me, from AEI, and they outline the work of their joint commission on US rural prosperity. And it goes on to developing a national rural strategy in reimagining rural policy for the 21st century.
Lot of great content, a lot of great research that you're gonna be doing on the road. But Matt, one of the reasons I wanted to have you here is that given the place that we're in, the reality of where we are right now with major dis investments in rural, and as you wrote in your July 23rd blog, rural communities get hit twice.
So how do we reimagine rural policy, not only with less federal investments, but policies that are really putting rural people, economies, and communities at risk?
Matthew Hildreth: Yeah, absolutely. So the reason I'm on the road right now is that I'm in Lancaster, Pennsylvania and we have what we're calling the 2050 Festival, which is a festival for rural civic leaders that are focused on the next generation. And it's all about, you know, building that vision from the ground up for the future of rural America.
But the first step is all about what we're doing right now, which is protecting really critical rural infrastructure like Medicaid and food assistance programs and things like that. Like we really feel like, as we are envisioning a future for rural communities that we need to, to be, you know, very much connected into what's happening right now.
And what we're seeing is that especially for rural communities, their costs are going up and the services are going down. And so that's what I mean when we are saying we're getting hit twice, is that a lot of the services that we rely on in small towns and rural communities. Things like Medicaid that support rural hospitals or food assistance SNAP that benefits farmers, but also benefits, people that are working and pay and living paycheck to paycheck.
Those services are going down. Meanwhile, the costs especially associated with the tariffs and things like that are going up. So, it's really putting small towns in rural, in rural communities in a bind. And I think we're seeing a lot of the impacts, from the current policy landscape on rural America, we're seeing those impacts first in rural America.
It really kind of feels like we're the canaries in the coal mine here.
Michelle Rathman: Yeah, it really does. And what I find so interesting is that for folks who live in urban or metropolitan areas thinking that this is not a problem that's gonna hit them. I mean, we know that when I said this very often, when rural fails, we all falter. All of us because there's, we we're connected whether we wanna believe it or not.
I really wanna talk to you, I'm glad that you brought up the Medicaid and the campaign to defend Medicaid because that might again, not be what young people today are thinking about. 'Cause they may not be, although we know how many children across rural America are, are insured through Medicaid. Talk to us about the campaign for Medicaid. 'cause it is the most, in my view, the most, and there are many pressing matters before us.
Matthew Hildreth: Yeah, so right now we have organizers in eight different congressional districts across six different states, and it's really about elevating the rural voices, small town voices of people impacted by Medicaid. And those voices aren't just the people that receive Medicaid benefits. They're also like the hospital CEOs, doctors, nurses, you know, some of the best jobs in small towns and rural communities are in healthcare.
There's more rural Americans working in healthcare and education than in manufacturing and in agriculture. So for us, when we talk about Medicaid, it's not just about the people that are, you know, getting the direct benefit, but also the community that benefits from Medicaid.
And so we see right now there are hospitals across the country that are at risk of closing. And a lot of those places, especially like I think about Kentucky's six congressional district where you have six hospitals in one congressional district at risk of closing, and that all has to do with really complicated policy decisions about reimbursement rates and all these other things.
But the, you know, the simple line on it is that. When, when those benefits are cut, the whole community really feels the impact. So that's why we're focusing on there. Medicaid is and healthcare is a huge,concern for a lot of small towns and rural folks, and housing, childcare, senior care, things like that are what we really tend to focus on.
I.
Michelle Rathman: Yeah. And so I you know, 'cause on this podcast we connect the dots between policy and quality of life. And the next question I have for you, because I've been thinking about this a lot, and not just because of what's happening in Texas, but you know, there is this, I fear a, a surge of efforts to redistrict rural America and challenge really their electoral relevance. Although, you know, in the last, in the last couple elections that I can remember, it's like, you know, but rural, this rural voted for that and whatnot.
So what do you think, I mean, 'cause you talk in terms of congressional districts, what do you foresee happening with all of this redistricting and, and rural, and how in the world do we have equitable policy when that happens?
Matthew Hildreth: Yeah, that's a great question. And I think the United States is one of the only advanced countries that, you know, democracies that politicians could pick the voters. The voters don't just pick the politicians. And so a lot of that stuff gets real complicated really quickly. But what I can say, I spent a lot of time in northwest Iowa.
And the best place you can be as an advocate is in a battleground district. And in a place like Iowa, we used to joke for the Iowa Caucus. You know, we didn't know who we were gonna vote for president 'cause we only met them one or two times. The idea would be that you would, you know be able to meet the politicians, the people that were running for elected office.
They would come into your community, they would actually talk about the issues impacting you. But what we see with, with gerrymandering is that the districts are getting so red in red states or so blue in blue states that politicians don't feel like they need to go there anymore. Republicans in red states feel like they don't need to go to the rural red areas because they can just count on the vote no matter what happens from the Republican voters in that district.
It happens in blue states too. If you're, you know, anybody that lives in a rural community in a blue state, especially a state where, you know, the majority of voters live in more urban areas, those, those people are getting ignored as well. So I think whatwe really wanna see, is we wanna see, you know, districts cut fairly and in a way that politicians really need to show up in those districts and they can't take anybody for granted.
And I think that's what we're seeing in Texas and we're seeing it in a lot of places,
Michelle Rathman: Yeah, honestly. Honestly, I think as, when we talk about dangers, I can't think of another where that we're rendering people electorally irrelevant as a result of it. So, I, you, you got a lot on your plate. So, I have a closing question for you, Matt, and anything else that you wanna offer. You know, we talk about advocacy tools and strategies and it can, we have a lot of headwinds on, on every front of where policy is concerned. What do you think is most critical for us to be focused on moving forward into 2026. 'Cause listen, everyone who thinks that they, they say, I don't wanna talk about politics or policy, but I got news for you. Every part of your life is touched by it as we know. So what do we need to be thinking about?
And not just thinking about, but doing ,organizing. And you guys are really good at it, so lay it on us.
Matthew Hildreth: Yeah. Yeah. So I, I think, you know, the question that I always ask myself, especially when it comes to policy and, and you know, I grew up, in a conservative religious household, and there there's an old saying that the Jesuits have, which is if you turn on a light switch, it's political, right? Like everything we do in our life has some connection to policy, into politics.
So that's how I think about things. But the way that we think about, engaging in rural. In small towns and rural communities is by addressing what, what the sociologists call civic deserts. And the fact is, is that 60% of rural youth live in a civic desert. And these are places where there's only one institution or no institution focused out of making meaning out of democracy and out of small p politics.
And so these are people that don't have local community, organizations to belong to. These are people that don't have a strong connection to the formal advocacy world that's out there. But in these places, so much of civic life, so much of local leadership is built around volunteer volunteerism.
It's about just everyday citizens getting involved in their communities. So that's something that we really focus on is how do we get everyday folks involved in, in their local community, their local civic life? If you live in a rural area or a small town, you know that the fire department is all volunteer run.
And you know, the mayor is often an unpaid position and the city council is all volunteer. And so those are the places where we're really trying to focus on getting peopleto the table. And as we're doing that, we always ask ourselves kind of two questions. Do voters know about a policy and do they like it?
And there's so many complicated metrics out there about evaluating this policy or that policy, but at the end of the day, for those of us in rural America, this is, a lot of this is personal. You know, people say politics, all politics is local. But in small towns and rural communities, it's really personal.
And, we are wanting to make sure that people have an idea and they know what's happening. They know how Medicaid, which sometimes just sounds like a big idea from the federal government in Washington, DC. They don't know that Medicaid is directly connected to the hospital down the street or in the town over.
And there's not been a ton of focus on, on bringing that civic engagement to civic deserts. And that's why we're so focused on Gen Z and millennials because we know through polling and through public opinion research that Gen Z millennials are ready to lead and that the majority of rural youth are wanting to get involved.
We just have to ask, ask them, and we have to be able to bring them into the process. And so that's what we're really focused on at Rural Organizing.
Michelle Rathman: So, let me ask you this, you know, anecdotally, or if you have an example, I mean, what, when, when you're talking about getting the younger folks involved, that next generation of leaders, what are some of the successes? I mean, when they come and they're curious, what are some of the big issues that you think are really drawing in young people so that our listeners can say, “yeah, we, we talk about it there's nothing for the young people to do. Well, how do we engage them?”
And, and, and have them, and have them lead?
Matthew Hildreth: Yeah, I mean, that's what we're doing here in Lancaster with 2050 Fest. You know, we have music during the day. It's all about workshops and panels and trainings. At night. We have a concert. We have actually some pretty big artists that are gonna be playing. It's at a concert venue.
We're having, you know, cornhole and there's a Mario Kart tournament as well, so we really wanna have fun. I think sometimes the work that we do is so serious and, and especially now with Medicaid that, you know, there's things that are matters of life and death, but really we wanna have fun and we wanna bring people in and actually empower them.
It's not just about. You know, getting young people involved in something that we're doing. It's about figuring out what is it that young people wanna do and us getting behind them. So, you talked about quality of life. I mean, the three things that we focus on at Rural America or at the three things we focus on at Rural Organizing is one, increasing, , paychecks, two is decreasing daily expenses, and then three is that quality of life.
And so, we actually are starting with arts and culture with, with bringing people together around music and food. We're gonna have food trucks today, and getting people involved on that first. And then, second, we can kind of have a, a, a deeper conversation about, okay, now how do you run for school board? How do you run for mayor? How do you get involved in city council?
And I think that that's why we're having a lot of success is because we, you know, start with having fun. And then we talk about the issues that increase their paychecks and decrease their daily expenses. Right now, especially focusing on daily expenses is absolutely critical.
And you know, there's a lot that that's happening right now. You know, as the federal government is cutting funding for rural counties, small towns and rural counties, people don't know that that's gonna raise their local taxes. And so if we're talking about keeping taxes low, that's one of the critical things that we're seeing from the federal money that came in from 2020 through 2024.
There was a ton of money that came from the federal government directly into the counties that's keeping the cost of living low. Because as you know, when you're in a small town or rural community, the number one thing you're focusing on is the highest quality of life with the lowest cost of living.
That's why people choose to live in a rural area. 'Cause you can have a bigger house on a smaller paycheck. And so, focusing on that equation and then connecting it to the younger generation, making sure that people are having fun. I think that's where we're seeing a lot of success.
Michelle Rathman: Yeah, that's fantastic. Oh, my goodness, I wish I was there with you, to be honest with you. It sounds like a great time. Matt, thank you so much for joining us, we're gonna make sure that we put links to your organization on theruralimpact.com website because I know you've got a toolkit. You guys are willing to talk to any community who wants to, to learn what you're doing, and we'll certainly be following your work.
And you're welcome back anytime. Thank you so much.
Matthew Hildreth: yYeah. Thank you so much.
Michelle Rathman: All right. Don't go anywhere. I'll be right back with a closing message. See you soon.
Michelle Rathman: Today was certainly a packed episode to be sure. So thanks for sticking with us, and my thanks to Tony, to Brent, and to Matt once again, for all the great information and resources and speaking of resources, head on over to theruralimpact.com, and that's where you can get links to all the resources that we talked about on today's show.
And that is also the place where you could take two seconds and subscribe to our newsletter. You'll get it in your inbox automatically and you won't miss a thing. All right. Also, I wanna remind you that we would love to have you follow us on social. You can find us on LinkedIn, Facebook, on Blue Sky especially, so we'd love to engage with you there.
A very special thank you to Brea Corsaro and Sarah Staub for all their great work behind the scenes. And until we are together again, I do invite you, as I always do, to please take really good care of yourself and to the best of your ability. Those around you. It's been a pleasure to be with you here today, and we will see you soon on a new episode of The Rural Impact.
