Federal Cuts From MAGA Republicans Threaten Hospitals, Schools, and Small-Town Civic Life. Here’s How We Are Fighting Back
Across rural America, families are waking up to some harsh realities, especially after Trump signed the new MAGA Republican budget, which was recently passed through the House and Senate.
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Local, rural organizing is more important now than ever before. In too many of our communities, hospitals are closing, schools are being defunded, and costs are rising, while essential services are vanishing. It’s a frustrating pattern that we’ve witnessed in countless small towns and rural communities.
But now, more than at any point in my professional career, the lifelines that keep small-town America alive—healthcare and education—are under coordinated attack, and the consequences are already being felt in kitchens, classrooms, and clinics from Kentucky to California.
Families are now forced to make impossible decisions. Can they move back to their hometown to care for aging parents if the local school might close? Can they afford to have another child if the nearest maternity ward just shut down? Can they open a small business in a town that’s losing its teachers and nurses to bigger cities?
These aren’t abstract questions—they’re decisions being made every day in communities across the country.
Schools in the Crosshairs
Earlier this month, Elon Musk and MAGA Republicans froze nearly $7 billion in federal education funding that had already been passed by Congress and signed into law. That money, designated for teacher training, after-school programs, summer learning, and support for English learners, was put “under review” with no explanation and no timeline.
The decision to withhold billions in federal education funding threatens critical support in low-income and rural districts that are already underfunded. Without after-school programs, summer learning opportunities, and resources for English language learners, the achievement gap between rural and urban students will continue to widen.
For many rural school districts operating on razor-thin budgets, this abrupt decision pushed them to the brink of crisis. Educators canceled summer programs, paused critical hires, and alerted families that student support services might not return in the fall.
At the same time, Congress passed what MAGA Republican leaders are calling the One Big Beautiful Bill. Behind the slogan is a devastating reality: $930 billion cut from Medicaid, the elimination of food assistance and clean energy tax credits, and the dismantling of rural development programs, just to give massive tax breaks to billionaires.
These cuts come at a time when more rural Americans work in healthcare and education than in agriculture. These cuts aren’t just jobs—they’re the scaffolding that supports the rural way of life.
Anyone in a small town knows that without good hospitals and schools, rural communities can’t attract new families, grow local businesses, or plan for the future.
Medicaid: A Rural Lifeline on the Chopping Block
Medicaid is one of the most vital support systems for rural America, recently targeted by MAGA Republicans. Nearly 1 in 4 rural residents relies on Medicaid for health coverage. In states such as Kentucky and Montana, over half of Medicaid enrollees live in rural areas.
Medicaid isn’t just for the poor—it’s for families who make too much to qualify for other support but not enough to afford private insurance. It covers nearly half of all births in rural hospitals and provides essential coverage for chronic conditions such as diabetes, asthma, and heart disease.
In states that expanded Medicaid under the Affordable Care Act, rural residents are significantly more likely to have health coverage and less likely to delay care due to cost. In these same states, 82% of rural Medicaid enrollees accessed care in the past year, compared to just 74% in non-expansion states.
But under the new legislation passed by MAGA Republicans, these benefits are on the verge of collapse. According to the Kaiser Family Foundation (KFF), federal Medicaid spending in rural areas is projected to decrease by $155 billion, more than triple the $50 billion allocated to a new rural health fund intended to mitigate the impact. In short, the "fig leaf" funding falls short of what is needed to keep rural hospitals afloat.
A Healthcare Crisis Decades in the Making
Nearly a third of all rural hospitals in the country are currently at risk of shutting their doors. In many areas, these hospitals are the sole source of emergency care within a 50-mile radius. Their closure forces residents to travel hours for urgent needs like childbirth, trauma care, or mental health treatment. It’s already started. Last week, a community hospital in rural Nebraska announced its closure was “driven by anticipated federal budget cuts to Medicaid.”
The economic impact is just as severe. Rural hospitals are often the largest employers in their communities, and when they close, it sets off a cascade of job losses, business closures, and population decline.
Adding to this crisis is a rising mortality rate in rural communities. A recent USDA report found that natural-cause mortality rates among working-age adults are rising in rural areas, especially among women, while those rates are declining in urban America. Today, rural residents are 43% more likely to die of natural causes than our urban counterparts. These aren’t isolated tragedies—they’re the results of systemic policy failures.
FEMA Cuts Leave Rural Communities Defenseless in a Changing Climate
On top of cuts to healthcare and education, rural communities are now being left vulnerable to climate disasters—with shrinking federal support. The Trump administration’s 2025 budget slashed over $4 billion from FEMA’s disaster preparedness and response programs, gutting grants that help small towns prepare for floods, fires, tornadoes, and extreme heat.
Even worse, FEMA’s mission has been redirected toward immigration enforcement, diverting emergency resources to border surveillance. With climate disasters growing more intense, these cuts don’t just threaten lives—they leave rural America to rebuild alone, again and again.
The Campaign for Rural Prosperity: A Movement on the Ground
In response to this growing crisis, RuralOrganizing.org has launched the Campaign for Rural Prosperity, a multi-year effort to defend and strengthen the essential services that sustain rural communities. The campaign is active in several key battleground congressional districts, including areas in Wisconsin, Kentucky, and Arizona, with plans to expand to eight more districts during the August recess.
In places like KY-06, where six rural hospitals are on the brink of closure, local organizers are raising awareness, sharing stories, and pressuring lawmakers. The campaign has already distributed over 3,000 “Protect Our Hospitals—No Cuts to Medicaid” yard signs, each one intended to spark community conversations and increase the visibility of the stakes involved.
Rural Hospitals That Will Likely Close in Battleground House Districts
The Work Ahead
We are organizing where it matters most. We’ve identified Medicaid-dependent, at-risk hospitals like MCHS Oakridge in Osseo, Wisconsin, and Saint Joseph Mount Sterling in Kentucky.
Our strategy includes:
Uplifting rural Medicaid stories from nurses, teachers, veterans, caregivers, and parents.
Generating earned media through op-eds, press events, and local storytelling.
Distributing 3,000+ “Protect Our Hospitals—No Cuts to Medicaid” yard signs, proven to generate five local conversations each.
We’ve already reached tens of thousands of households and earned hundreds of media placements. But we are just getting started.
We Are In A Moment of Both Urgency and Possibility
The challenges are undeniable, but so is the resolve. Across the country, rural Americans are standing up for their communities.
Our small towns are not a charity case. Our hometowns are the engine that keeps this country running—from food and energy to small businesses and public service. We deserve healthcare, education, and dignity—not cuts, closures, and corporate giveaways.
Looking beyond short-term defense, RuralOrganizing is investing in long-term leadership development. On August 9, the organization will host 2050 Fest in Lancaster, Pennsylvania—a civic and cultural gathering designed to inspire and mobilize a new generation of rural organizers, artists, and changemakers.
2050 Fest will mark the launch of the Rural 2050 Initiative, a 25-year vision to build an inclusive and sustainable future for rural America. The event will feature music, workshops, podcast recordings, and strategy sessions that connect policy with lived experience. The goal is to spark new leadership pipelines and rebuild the civic infrastructure that decades of disinvestment have eroded.
This is our moment to fight back—and to build forward. While MAGA Republicans push an agenda that strips rural communities of the tools we need to thrive, RuralOrganizing.org and everyday people across the country are forging a different path—one rooted in care, connection, and common sense. We’re not just defending what we have left; we’re reimagining what’s possible. From local town halls to national campaigns, from classrooms to clinics, rural Americans are rising to say: We will not be overlooked. We will not be left behind. And together, we will build a rural future that works for all of us.