Rural Dispatch: June 2025
Native Americans Hurt by Federal Health Cuts, Despite RFK Jr.’s Promises of Protection
Katheryn Houghton and Jazmin Orozco Rodriguez and Arielle Zionts
The Indian Health Service was mostly spared in the federal government’s widespread staffing cuts, but tribal governments and organizations have lost funding elsewhere in the melee of federal health agency cuts.
‘We Need To Keep Fighting’: HIV Activists Organize To Save Lives as Trump Guts Funding
Amy Maxmen
While Congress fails to stave off cuts to HIV care, community leaders in Mississippi and beyond race to limit the damage.
Ballad Health’s Hospital Monopoly Underperformed. Then Tennessee Lowered the Bar.
Brett Kelman
Ballad Health, a state-sanctioned hospital monopoly in Tennessee and Virginia, can now be deemed a “clear and convincing” benefit to the public with performance that would earn a “D” on most grading scales, according to Tennessee state documents.
Supreme Court Upholds Bans on Gender-Affirming Care
The Supreme Court this week said Tennessee may continue to enforce its law banning most types of gender-affirming care for minors. The ruling is likely to greenlight similar laws in two dozen states. And the Senate is preparing to vote on a budget reconciliation bill that includes even deeper Medicaid cuts than the House version. Victoria Knight of Axios, Alice Miranda Ollstein of Politico, and Sandhya Raman of CQ Roll Call join KFF Health News’ Julie Rovner to discuss these stories and more.
The Price You Pay for an Obamacare Plan Could Surge Next Year
Daniel Chang
An estimated 4 million Americans will lose health insurance over the next decade if Congress doesn’t extend enhanced subsidies for Affordable Care Act marketplace coverage, which expire at the end of the year. Florida and Texas would see the biggest losses, in part because they have not expanded Medicaid eligibility.
Watch: In a ‘Dead Zone,’ Doctors Don’t Practice and Telehealth Doesn’t Reach
Sarah Jane Tribble
Chief rural health correspondent Sarah Jane Tribble explains how millions of rural Americans live in counties with doctor shortages and where high-speed internet connections aren’t adequate to access advanced telehealth services.
In a Dusty Corner of California, Trump’s Threatened Cuts to Asthma Care Raise Fears
Miranda Green
The Trump administration wants to shutter the CDC’s National Asthma Control Program, which provides millions in funding to state-administered initiatives aimed at fighting the disease. The program’s closure, combined with massive cuts to environmental programs, could put the 28 million Americans with asthma at increased risk.
‘One Big Beautiful Bill’ Would Batter Rural Hospital Finances, Researchers Say
Jazmin Orozco Rodriguez
Rural hospitals would take an outsize hit from Republicans’ proposed cuts to Medicaid and other federal health programs. Researchers say the financial erosion would trigger hospital closures and service cuts, especially in communities where large shares of patients are enrolled in Medicaid.
Trump Team’s Reworking Delays Billions in Broadband Build-Out
Sarah Jane Tribble
A Trump administration reworking of a $42 billion broadband expansion program will trigger delays as millions of rural Americans wait for promised connections and the telehealth services they bring.
Journalists Draw Link Between Internet Dead Zones, Threatened Medicaid Cuts, and Health
KFF Health News journalists made the rounds on national or local media recently to discuss topical stories. Here’s a collection of their appearances.
Feds Chop Enforcement Staff and Halt Rules Meant To Curb Black Lung in Coal Miners
Taylor Sisk
The Trump administration has paused implementation of a rule limiting miners’ exposure to airborne silica dust days after a federal court agreed to put it on hold to hear an industry challenge. The protections are meant to head off a surge in cases of black lung disease. Meanwhile, any enforcement of new standards might be meager due to workforce cuts.
In Arizona County That Backed Trump, Conflicted Feelings About Cutting Medicaid
Noam N. Levey
Medicaid plays a vital role in many rural communities that favored President Donald Trump in the 2024 election. But residents still seem open to Republican proposals to cut perceived waste in the program.
Federal Cuts Ripple Through a Bioscience Hub in Rural Montana
Katheryn Houghton
The National Institutes of Health’s Rocky Mountain Laboratories in Hamilton, Montana, is one of only a few dozen research facilities of its type. The threat of staffing and grant cuts has town leaders worried and has added to long-standing tension around the lab’s presence in this politically conservative region.
A Medicaid Patient Had a Heart Attack While Traveling. He Owed Almost $78,000.
Arielle Zionts
Federal law says Medicaid must cover out-of-state emergency care. But a Florida man got a five-figure bill after a South Dakota hospital declined to charge his state’s Medicaid program.