In this episode of The Rural Impact, host Michelle Rathman welcomes Liz Hamel, Senior Vice President and Director of Public Opinion and Survey Research at KFF, and Sarah Jane Tribble, Senior Correspondent and Lead Reporter with KFF Health News, to discuss findings from the KFF/AP Rural Voter Survey of more than 2,200 registered rural voters.

The conversation explores how economic pressures, healthcare policies, and access to essential services are influencing rural voters' priorities and political perspectives. Michelle and her guests examine voter enthusiasm, trust in elections, the role of immigration in rural economies, and growing concerns about healthcare provider shortages. Despite mounting financial challenges, the discussion also highlights rural Americans' strong connections to their communities and the importance of understanding their experiences beyond political affiliations.

As registered rural voters prepare to cast their vote, via mail, drop box or at the polls, this conversation offers important insights into the issues shaping their decisions and what those priorities could mean for the future of rural America.

Learn More
Explore the survey at KFF.org and related reporting at KFF Health News.

In this episode of The Rural Impact, Michelle Rathman welcomes Becky Payne, President and CEO of The Rippel Foundation, for a timely conversation about the state of well-being in America and what communities can do to create meaningful change.

Drawing from the newly released Thriving Together in America report, Michelle and Becky explore declining well-being, particularly among young adults, the seven Vital Conditions that shape our daily lives, and the critical role of belonging and civic muscle. They also discuss why addressing complex community challenges requires moving beyond individual programs and bringing healthcare, government, businesses, nonprofits, and residents together.

For rural leaders, the conversation offers an important reminder: communities have more power and agency than they may realize. By listening, measuring what matters, strengthening local relationships, and investing in the conditions that help people thrive, communities can turn hope into action.

Land use decisions are shaping the future of rural America—from the rapid growth of data centers to new opportunities for producing food and renewable energy on the same land.

In Part One of this episode, A Conversation about Land Use and Powering Rural, Michelle Rathman talks with Custer County Commissioner Jason Strouf and Umatilla County Commissioner John Shafer about data center development in their communities. They explore the economic opportunities these projects can create, along with questions about land use, water, infrastructure, private property rights, local planning, and the importance of involving rural residents in decisions with long-term impacts.

In Part Two, Michelle is joined by Rebekah Pierce, Owner and Operator of J&R Pierce Family Farm, as well as a freelance writer and author of Agri-Energy: Growing Power, Growing Food. Pierce shares how her family farm uses sheep and cattle to manage vegetation on community-scale solar sites, allowing the same land to support both food and energy production. She discusses solar grazing, farm economics, land preservation, animal health, renewable energy policy, and why farmers need a meaningful voice in conversations about the future of agricultural land.

Two different approaches to land use. One larger conversation about powering rural communities while protecting the people, land, and livelihoods that make them rural—and ensuring rural voices help shape that future.

In this episode of The Rural Impact, host Michelle Rathman sits down with Leslie Dach, Founder and Chair of Protect Our Care, for a conversation about what these policy changes mean for rural communities and why the impact extends far beyond insurance coverage.

Leslie explains why rural Americans are particularly vulnerable to changes in Medicaid and the Affordable Care Act. With rural hospitals already operating on extremely tight margins and many communities having lost services such as maternity care, reductions in coverage can have consequences for both patients and the healthcare infrastructure they depend on.

Michelle and Leslie also explore the connection between healthcare access and the broader rural quality-of-life picture. When people cannot afford preventive care, medications, or insurance, or when the nearest hospital, clinic, pharmacy, or provider becomes harder to access—the effects can ripple through families, healthcare organizations, employers, and local economies.

The conversation also examines the role of the $50 billion Rural Health Transformation Program. While the program represents a significant federal investment in rural health, Michelle and Leslie discuss whether transformation funding can achieve its intended purpose when healthcare organizations are simultaneously confronting substantial losses elsewhere in the system.

This episode was made possible by our partner, The National Association of Rural Health Clinics.

Join the National Association of Rural Health Clinics in Louisville, Kentucky, September 28 through October 1, for the NARHC Fall Institute, the only national conference designed exclusively for Rural Health Clinics.

Whether you're new to the RHC world or a seasoned leader, you'll gain valuable insights, make meaningful connections, and discover practical strategies to help your clinic thrive.

Register today at NARHC.org.

In this episode of The Rural Impact, host Michelle Rathman is joined by Heather O’Loughlin, Executive Director of the Montana Budget and Policy Center, to explore the policies and economic decisions affecting healthcare access and rural quality of life across Montana.

Their conversation examines Montana’s implementation of Medicaid community engagement and work reporting requirements, including concerns that additional administrative requirements could contribute to coverage losses. Michelle and Heather also discuss how state budget decisions can impact rural providers, workforce retention and access to essential services.

The conversation underscores just how interconnected the policies shaping rural communities truly are. From Medicaid coverage and workforce shortages to sustainable funding, maternal healthcare and essential public services, decisions in one area can create ripple effects across an entire community. As Montana moves forward with new rural health investments, the discussion highlights the importance of considering the broader policy environment necessary to create meaningful, sustainable improvements in rural health and quality of life.

This episode was made possible by our partner, The National Association of Rural Health Clinics.

Join the National Association of Rural Health Clinics in Louisville, Kentucky, September 28 through October 1, for the NARHC Fall Institute, the only national conference designed exclusively for Rural Health Clinics.

Whether you're new to the RHC world or a seasoned leader, you'll gain valuable insights, make meaningful connections, and discover practical strategies to help your clinic thrive.

Register today at NARHC.org.

One year after the passage of H.R.1 and the creation of the $50 billion Rural Health Transformation Program (RHTP), The Rural Impact revisits one of the most significant policy shifts affecting rural healthcare. Host Michelle Rathman is joined by three nationally recognized rural health leaders to discuss what's changed, what challenges remain, and where opportunities for innovation are emerging.

In Part One, Michelle speaks with Alan Morgan, CEO of the National Rural Health Association (NRHA), who evaluates the first year of H.R.1. Alan explains why he would currently give the program an "Incomplete," noting that while funding has reached states, many are only beginning implementation. The conversation also explores Medicaid payment reforms, work requirements, and ongoing concerns about rural hospital sustainability.

In Part Two, Jed Hansen, PhD, APRN, FNP-C, Executive Director of the Nebraska Rural Health Association, shares a frontline perspective on rural health transformation. He discusses Nebraska's priorities, including workforce development, technology, behavioral health, and food security, while addressing the challenges of Medicaid work requirements and sustaining essential healthcare services, as well as Veterans’ access to healthcare.

Finally, in the debut of Voices of Impact, Michelle welcomes Kait Guild, Assistant Director of Mobile Health MAP and The Family Van at Harvard Medical School. Kait explains why mobile healthcare should be treated as essential healthcare infrastructure and highlights the need for long-term sustainability as states expand mobile health services through Rural Health Transformation funding.

This episode was made possible by our partner, The National Association of Rural Health Clinics.

Join the National Association of Rural Health Clinics in Louisville, Kentucky, September 28 through October 1, for the NARHC Fall Institute, the only national conference designed exclusively for Rural Health Clinics.

Whether you're new to the RHC world or a seasoned leader, you'll gain valuable insights, make meaningful connections, and discover practical strategies to help your clinic thrive.

Register today at NARHC.org.

For more than a century, why has rural America been described as being "in crisis"? In this thought-provoking episode of The Rural Impact, host Michelle Rathman sits down with historian and author Steven Conn to explore the myths, realities, and historical forces that continue to shape rural America.

Drawing from his book Lies of the Land: Seeing Rural America for What It Is—and What It Isn't, Conn challenges many assumptions that dominate conversations about rural communities. Together, Michelle and Steven examine how America's founding ideals, military expansion, industrial development, corporate influence, and public policy have shaped today's rural landscape, and why understanding that history is essential to creating stronger rural futures.

The conversation explores why the idea of a perpetual "rural crisis" may be rooted more in national mythology than historical reality, how economic development strategies have often left rural communities vulnerable, and why policies surrounding healthcare, infrastructure, transportation, broadband, and economic investment must account for the realities of low-density living. Conn also offers a compelling distinction between rural "space" and rural "place," emphasizing that thriving communities are built through people, connection, and intentional investment—not simply geography.

This episode was made possible by our partner, The National Association of Rural Health Clinics.

Join the National Association of Rural Health Clinics in Louisville, Kentucky, September 28 through October 1, for the NARHC Fall Institute, the only national conference designed exclusively for Rural Health Clinics.

Whether you're new to the RHC world or a seasoned leader, you'll gain valuable insights, make meaningful connections, and discover practical strategies to help your clinic thrive.

Register today at NARHC.org.

As artificial intelligence expands and the demand for digital infrastructure accelerates, rural America is increasingly at the center of conversations and controversies over energy production, data centers, land use, and economic development. But who benefits from these projects, who bears the costs, and how can rural communities ensure they have a meaningful voice in decisions that will shape their future? In this episode, Michelle Rathman welcomes community and economic development expert John C. Shepard for a thoughtful discussion about the opportunities and challenges surrounding data center development and the growing demand for energy infrastructure in rural communities.

Together, they examine why data centers have become one of the most significant and controversial topics facing rural leaders today. The conversation explores how local governments can balance economic development with responsible land use, environmental stewardship, infrastructure planning, and community quality of life. Shepard explains why transparency, comprehensive planning, and strong local governance are essential as communities navigate proposals from large corporate developers seeking land, water, and power resources.

The discussion also highlights practical strategies for local officials, planners, and community leaders, emphasizing the importance of asking questions, building partnerships, protecting community interests, and ensuring rural communities remain active participants, not passive recipients, in shaping their future.

This episode was made possible by our partner, The National Association of Rural Health Clinics.

Join the National Association of Rural Health Clinics in Louisville, Kentucky, September 28 through October 1, for the NARHC Fall Institute, the only national conference designed exclusively for Rural Health Clinics.

Whether you're new to the RHC world or a seasoned leader, you'll gain valuable insights, make meaningful connections, and discover practical strategies to help your clinic thrive. Register today at

NARHC.org.

RESOURCES:

- https://www.brookings.edu/articles/local-implications-data-centers-rural-communities-us/
- https://jcshepard.com/2026/06/the-full-energy-picture-in-2026/
- https://www.narhc.org/narhc/Conferences.asp