Rural Dispatch: Dec. 19, 2025
Oregon Hospital Races To Build a Tsunami Shelter as FEMA Fights To Cut Its Funding
Hannah Norman and Daniel Chang
Columbia Memorial Hospital near Oregon’s coastline planned to add a tsunami shelter, counting on a FEMA grant. After the Trump administration cut the funding, hospital officials are building anyway, saying waiting is too risky. A judge ruled Dec. 11 that the administration unlawfully ended the program without congressional approval.
In the Vast Expanses of Indian Country, Broadband Gaps Create Health Gaps, Too
Sarah Jane Tribble
On Idaho’s remote Fort Hall Reservation, thousands live without reliable high-speed internet, which supports health care, education, and daily life. Facing delays and wavering federal policy, Frances Goli is determined to spend more than $22 million in federal grant money before she runs out of time.
One Big Beautiful Bill Act Complicates State Health Care Affordability Efforts
Bernard J. Wolfson
The federal budget bill President Donald Trump signed into law in July is creating uncertainty for states trying to rein in health care spending. In California, a lawsuit by the hospital industry challenging state spending caps cites the law, which will slash Medicaid spending, as one of many financial pressures.
Sticker Shock: Obamacare Customers Confront Premium Spikes as Congress Dithers
Julie Appleby
With subsidies that give consumers extra help paying their health insurance premiums set to expire, lawmakers are again debating the Affordable Care Act. The difference this time: It’s happening in the middle of ACA open enrollment.
While Scientists Race To Study Spread of Measles in US, Kennedy Unravels Hard-Won Gains
Amy Maxmen
Scientists are conducting genetic analyses to see if the measles outbreak that started in Texas is still spreading from state to state. It’s a contentious question, because the findings may determine whether America loses its measles-free status.
RFK Jr. Wants To Delay the Hepatitis B Vaccine. Here’s What Parents Need To Know.
Jackie Fortiér
A CDC panel is reconsidering the birth dose of the hepatitis B vaccine. Renewed doubt could lead to fewer kids getting vaccinated, leaving them vulnerable to an incurable, preventable virus that can be acquired by indirect contact with infected blood.
Feds Promised ‘Radical Transparency’ but Are Withholding Rural Health Fund Applications
Sarah Jane Tribble and Arielle Zionts
Proposals from states that have shared their applications to a new $50 billion rural health program include using drones to deliver medication, installing refrigerators to expand access to healthy produce, and bringing telehealth to libraries, day cares, and senior centers.
Even as SNAP Resumes, New Work Rules Threaten Access for Years To Come
Renuka Rayasam and Katheryn Houghton and Samantha Liss
Even as the federal government resumed funding the nation’s largest food assistance program, people risk losing access to the aid because of new rules.
Republicans Left Tribes Out of Their $50B Rural Fund. Now It’s Up to States To Share.
Jazmin Orozco Rodriguez
The Trump administration has championed its Rural Health Transformation Program as an investment in American families who have been left behind. But Native American tribes, whose communities have a significant presence in rural America and have some of the greatest health needs, are ineligible to apply directly for funding.
Feds Promised ‘Radical Transparency’ but Withhold $50B Rural Fund Details
Sarah Jane Tribble
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A North Carolina Hospital Was Slated To Open in 2025. Mired in Bureaucracy, It’s Still a Dirt Field.
Andrew Jones
Regulations meant to prevent unfettered health care expansion are withholding needed hospital beds in a rural part of North Carolina. Here, as in communities around the country, some officials and health care providers are contesting such “certificate of need” laws.
Rural Health Providers Could Be Collateral Damage From $100K Trump Visa Fee
Arielle Zionts and Phillip Reese
Dozens of health care organizations have asked the Trump administration to shield the doctors, nurses, and techs they need to fill shortages from the president’s new $100,000 visa fee for skilled foreign workers. So far, there’s no sign of a reprieve.
Disability Rights Lawyers Threatened With Budget Cuts, Reassignments
Tony Leys
The Trump administration wants deep funding cuts for state-based legal services for disabled people, as rights advocates say the Justice Department pushed out many of its lawyers who worked on such issues.
Journalists Talk Increasing Insurance Costs, From Marketplace Plans to Employer Coverage
KFF Health News journalists made the rounds on national and local media recently to discuss topical stories. Here’s a collection of their appearances.
More People Are Caring for Dying Loved Ones at Home. A New Orleans Nonprofit Is Showing Them How.
Halle Parker, Verite News
Demand for home health care, including at-home hospice care, has skyrocketed since the onset of the covid pandemic. A New Orleans nonprofit is teaching people how to provide end-of-life care for relatives and community members.
Not Serious Enough To Turn on the Siren, Toddler’s 39-Mile Ambulance Ride Still Cost Over $9,000
Tony Leys
After her son contracted a serious bacterial infection, an Ohio mother took the toddler to a nearby ER, and staffers there sent him to a children’s hospital in an ambulance. With no insurance, the family was hit with a $9,250 bill for the 40-minute ride.