The Rural Impact

Michelle's May Matters

In this solo Memorial Day and early summer episode of The Rural Impact, host Michelle Rathman shares reflections from the road while attending the National Rural Health Association Annual Meeting and previews several major policy conversations the podcast will continue exploring throughout 2026 and into 2027. Michelle discusses the expansion of the podcast’s “Tracking Transformation” series, examining rural health transformation funding, as well as upcoming conversations focused on the Farm Bill, federal education policy, election administration in rural counties, and how policy decisions continue shaping everyday life across rural America. The episode also explores concerns surrounding the rapid expansion of data centers in rural communities and the strain some projects are placing on local water resources. Michelle reflects on the importance of balancing technological growth with environmental stewardship while protecting public lands and access to clean water in rural regions. She also discusses ongoing concerns surrounding the United States Postal Service and the implications for rural communities that rely heavily on vote-by-mail systems and dependable postal infrastructure. Throughout the conversation, Michelle reinforces how policy decisions directly impact healthcare access, infrastructure, civic participation, and overall quality of life. A significant portion of the episode focuses on Medicaid work requirements and the potential consequences for rural healthcare systems. Michelle discusses Nebraska becoming the first state to implement Medicaid work requirements under H.R.1 and explains why healthcare experts believe many coverage losses will result from administrative reporting barriers rather than unemployment itself. Referencing lessons learned from Arkansas, she highlights how working individuals previously lost healthcare coverage because they were unable to successfully navigate reporting systems. Michelle closes the episode by reminding listeners that “all roads to quality of life are paved by policy” and encourages audiences to stay informed, engaged, and connected through future episodes of The Rural Impact and resources available at The Rural Impact.

Tracking Transformation: Federal Funding Forecast and States' Use of RHTP Funds with Maya Sandalow, Chris Nelson and Carrie Cochran-McClain

In this episode of The Rural Impact, host Michelle Rathman continues the "Tracking Transformation" series with a closer look at how states are using Rural Health Transformation Program (RHTP) funding to modernize rural healthcare through technology.  In part one, Michelle is joined by Maya Sandalow, Associate Director of the Bipartisan Policy Center, who discusses how investments in telehealth, remote patient monitoring, AI, and cybersecurity could reshape rural care delivery. Sandalow outlines key technology investment trends emerging from state RHTP plans and explains why infrastructure, implementation, and sustainability are critical to long-term transformation.  In part two, federal health policy expert Chris Nelson joins Michelle to discuss how states, particularly those working with indigenous populations and Veterans health services, are prioritizing technology and workforce investments through their RHTP plans. Nelson also highlights barriers to technology adoption and the growing urgency surrounding maternal healthcare access in rural America.  In the final segment, Michelle welcomes back Carrie Cochran-McClain, Chief Policy Officer for the National Rural Health Association, to discuss the policy landscape surrounding RHTP implementation. Carrie shares insight into the fast-moving rollout of funding and CMS accountability measures, as well as mounting concerns over looming Medicaid cuts and the financial pressures facing rural hospitals.   Because we're all about connecting the dots, the conversation also covers maternal health service closures, broadband investments, the Administration's FY27 federal budget proposal, and the ongoing push to advance the Farm Bill and other key rural health priorities.  RESOURCES: NRHA links: https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2026/fy-2027-approps-table-4-23-26.pdf [https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2026/fy-2027-approps-table-4-23-26.pdf] https://www.ruralhealth.us/advocacy/advocacy-press-center/nrha-press-releases [https://www.ruralhealth.us/advocacy/advocacy-press-center/nrha-press-releases] Report: Sustaining Rural Hospital Access https://bipartisanpolicy.org/report/sustaining-rural-hospital-access-adjustments-to-medicare-rural-hospital-designations/ [https://bipartisanpolicy.org/report/sustaining-rural-hospital-access-adjustments-to-medicare-rural-hospital-designations/] https://www.linkedin.com/in/chris-nelson-566392274/ [https://www.linkedin.com/in/chris-nelson-566392274/]

The Precarious State of Public Education with Paige Shoemaker Demio and Dr. Steven L. Johnson

In part one of this episode, The Precarious State of Public Education, host Michelle Rathman continues the series on the state of rural education with policy expert Paige Shoemaker DeMio. Paige is a Senior Policy Analyst for K-12 Education Policy at the Center for American Progress (CAP). Before joining CAP, she served as a secondary social studies teacher in Cleveland. As a former educator, she has a passion for developing education policies that will ensure an equitable education system in the United States.    Paige and Michelle explore how school voucher programs and broader “school choice” policies are disproportionately harming rural communities. Drawing on research from states like West Virginia, Indiana, and Vermont, Paige explains how these programs often redirect public funds to families already enrolled in private schools, leaving rural public schools with fewer resources despite fixed costs and limited local funding capacity. The discussion also highlights how these funding shifts contribute to school closures, reduced programming, and long-term impacts on rural communities where schools serve as economic and social anchors.    In part two, Dr. Steven L. Johnson, Superintendent in North Dakota, joins Michelle. Dr. Johnson is a member of the Executive Committee of the National Rural Education Association (NREA), where he co-chairs the Legislative Committee. With nearly 50 years in education, he has extensive experience in rural school leadership, policy, and district reorganization.   During their conversation, Dr. Johnson shares a ground-level perspective on how federal policy shifts and Department of Education disruptions are affecting rural districts in real time. He describes the operational chaos caused by delayed funding, staffing cuts, and loss of institutional knowledge, emphasizing how even small disruptions can destabilize already fragile rural systems.    The conversation broadens to include demographic decline, workforce challenges, and the importance of strategic adaptation, while also touching on interconnected issues like school meals and community sustainability. Dr. Johnson underscores the need for efficiency, direct funding, and practical solutions that prioritize students, reinforcing that rural schools must navigate uncertainty while remaining critical pillars of their communities.

Rural Counties Responding to Policy Shifts: The Impact of Civic Engagement with Hope Harmon, Paul Heimel and Chuck Marohn Jr.

In part one of this episode of The Rural Impact, “Rural Counties Responding to Policy Shifts: The Impact of Civic Engagement,” Michelle speaks with two rural leaders navigating complex policy challenges: Commissioners Hope Harmon and Paul W. Heimel. Harmon, a County Commissioner in Ben Hill County, Georgia, champions education, healthcare, economic development, and public safety. Heimel, in his 19th year as a County Commissioner in Potter County, Pennsylvania, focuses on community and economic development amid population decline and an aging population, while also advancing work in criminal justice reform, healthcare, veterans’ affairs, and arts-driven revitalization. In Michelle’s conversation with Commissioners Harmon and Heimel, they explore the growing strain federal policy shifts are placing on rural counties, from reduced funding and rising service costs to workforce shortages, healthcare access challenges, and population decline. Both Commissioners share firsthand insights into how their communities are adapting through budget tightening, restructuring services, and emphasizing the importance of civic engagement. They highlight the critical role of community involvement, local leadership, and innovative approaches, such as partnerships, grassroots events, and arts initiatives, in sustaining and strengthening rural communities despite limited resources. In the second part of the episode, Michelle is joined by Charles “Chuck” Marohn Jr., Founder and President of Strong Towns, an organization focused on helping communities build financial resilience and long-term sustainability through bottom-up development strategies. In his segment, Chuck and Michelle discuss how traditional top-down economic development models have contributed to financial fragility in rural communities. He emphasizes the need for incremental, locally driven growth, smarter infrastructure investment, and rethinking housing and development patterns to better align with the realities of small towns. He also underscores the importance of focusing on local action, encouraging individuals to engage in their communities, rebuild civic infrastructure, and take practical steps to create stronger, more resilient places to live. GUESTS: Hope Harmon, Ben Hill County Commissioner Paul W. Heimel, Potter County Commissioner Charles “Chuck” Marohn, Jr, Founder and President of Strong Towns

USPS Under Threat and the Impact on Rural with Elena Patel and Sarah Anderson

In part one of this episode, USPS Under Threat and the Impact on Rural America, Elena Patel, Co-Director of the Urban-Brookings Tax Policy Center, joins Michelle to break down the growing financial crisis facing the United States Postal Service. Elena shares insights from her recent research on the USPS funding model, explaining how the shift from letter mail to digital communication has disrupted a system that once sustained universal service. The conversation explores the Postal Service’s Universal Service Obligation and what it means to deliver affordable mail service to every address in the country, six days a week. They discuss the structural challenges USPS faces, including rising operational costs, limited borrowing authority, and increasing competition in package delivery. Elena also outlines potential policy solutions, emphasizing the critical role Congress must play in modernizing funding mechanisms to reflect today’s digital economy. The conversation highlights the broader implications for rural communities, small businesses, and essential services that rely on a stable and accessible postal system.   In part two of this episode, Sarah Anderson, Global Economy Director at the Institute for Policy Studies, joins Michelle to explore the deeper community impact of the Postal Service, particularly in rural America. The conversation examines how USPS functions as more than a delivery system, serving as a vital economic and social lifeline for rural residents. Sarah discusses the potential consequences of privatization, including increased costs, reduced service, and the possible closure of rural post offices. They also highlight the essential role USPS plays in delivering prescription medications, supporting small businesses, and ensuring access to vote-by-mail, especially in areas with limited polling locations. The discussion addresses workforce impacts, noting the importance of postal jobs as stable, middle-class employment in rural communities. Looking ahead, Sarah shares ideas for strengthening the Postal Service through expanded services, such as financial offerings and community-based programs, while reinforcing the importance of preserving USPS as a public good that serves all Americans.