Rural Dispatch: Tuesday, April 28, 2026
Rural Nebraska Dialysis Unit Closes Despite the State’s $219M in Rural Health Funding
Arielle Zionts
A rural Nebraska dialysis unit that was hemorrhaging money closed, upending patients’ lives. That’s despite a federal rural health program that granted the state more than $200 million this year to improve health care in rural communities.
Big Companies Position Themselves for Payday From $50B Federal Rural Health Fund
Sarah Jane Tribble
A $50 billion federal fund is supposed to modernize rural health with electronic health records, AI, telehealth, and more. But community clinics and rural health advocates fear that the contractors administering the money for states will bite off a big chunk before it reaches rural patients.
Food Stamp Work Rules Don’t Increase Employment, Researchers Say
Taylor Sisk
Work requirements will encourage people who are able to work to seek and maintain jobs, proponents say. But researchers haven’t found that they lower the unemployment rate.
New Federal Medicaid Rules Require One Month of Work. Some States Demand More.
Samantha Liss
Starting next year, about 18.5 million adults will be subject to new Medicaid work rules in 42 states and Washington, D.C. Applicants must show they’ve been working for at least a month before receiving benefits. Some Republican-controlled states want to triple the required work period.
Tax Time Brings Surprises for Some Who Receive ACA Subsidies
Julie Appleby and Andrew Jones
Some people find they owe money back for subsidies if their income changed from what they estimated. In 2026, more people may find themselves in this situation — and face higher repayment amounts — if they don’t carefully track their income.
Farm Bureau Health Plans Beat the ACA on Prices With an Age-Old Tactic: Rejecting Sick People
Michelle Andrews
Fourteen states now allow health coverage through state farm bureaus. Though they generally share many features of Affordable Care Act marketplace plans, they aren’t insurance. Neither are they typically subject to federal or state health insurance requirements, and the benefits may be less generous or predictable than those of Obamacare plans.
Urgent Care Clinics Move To Fill Abortion Care Gaps in Rural Areas
Kate Wells
When the only clinic that offered abortions in Michigan’s rural Upper Peninsula closed, an urgent care facility stepped in to fill the gap. Now, others are considering similar moves as brick-and-mortar clinics close in blue states.
This Northern Cheyenne Doula Was About To Start Getting Paid — Then Medicaid Cuts Hit
Katheryn Houghton
Montana was on track to start reimbursing doulas, who support new and expectant parents, through Medicaid this year. But state officials halted that plan amid a budget shortfall. Other such services deemed optional under Medicaid are at risk nationwide as states brace for federal cuts.
State-Run Insurance Plans for Foster Kids Leave Some of Them Without Doctors
Andrew Jones
North Carolina rolled out a $3.1 billion insurance plan for kids in foster care, but many doctors did not accept patients on the plan. The state is one of several experimenting with a model that has left kids’ guardians scrambling to find health care providers.
Pennsylvania Town Faces Fallout From Trump’s Environmental Rule Rollback
Stephanie Armour and Maia Rosenfeld
Even as the Trump administration publicly embraces the Make America Healthy Again movement and its ideals about reducing corporate harm to the environment, it has taken steps to stall environmental protections that MAHA followers hold dear.