Rural Healthcare

Substantial numbers of Virginians could either lose their healthcare coverage completely or see a significant increase in the cost of coverage, if the Trump administration and the Republicans in Congress follow through on rewriting the healthcare budget in March. This is because:

• 1.8 million Virginians receive health coverage through Medicaid, while nearly 400,000 receive coverage through Healthcare Marketplace.

• Those covered under the Healthcare Marketplace may not realize that the Affordable Care Act is the reason why their healthcare is relatively affordable. If the Republican-controlled Congress eliminates that support, these rural residents’ may be shocked to see their healthcare costs double or triple.

• Farmers are particularly reliant on the Healthcare Marketplace. Losing access to its affordable pricing would be a major blow to the family farm.

• Rural doctors and hospitals, already financially threatened, would be further hurt as more of their patients become un or under-insured.

THE BOTTOM LINE: The number of rural residents without health care has been cut in half over the last decade thanks to the expansion of Medicaid and the ACA. Yet, over half of the total spending cuts currently under discussion by House Republicans would come from healthcare alone. These cuts, if enacted in March, would force Virginia to choose between allowing a rural healthcare crisis to emerge or raising its own taxes to protect its rural residents. Stay tuned!

Agriculture and the Family Farm

Despite overwhelming voter support in rural areas, Trump has said relatively little about supporting family farms. Thus far, policy choices and trends in the last month appear to deprioritize the family farm. For example:

• New Trump tariffs on the three leading importers of American agricultural products (Canada, Mexico, and China) will damage US farm exports, as those countries turn to other providers they trust more. (The Canadian population is especially angry.). This will jeopardize $ billions of agricultural exports over the long term.

• USAID's elimination has taken $2 billion straight out of U.S. farmer's pockets from the Food for Peace program (which purchases rice, wheat, corn and soy from U.S. farmers).

• Although Trump in his first term spent heavily to compensate farmers for lost export markets due to tariffs, that will be much harder to do this time as he prioritizes massive budget reductions to pay for new or renewed tax cuts.

• The abrupt freezing or cancellation of $ billions of USDA reimbursements, contracts, programs and research has placed many farmers in a financial bind. No one knows what will happen to these programs.

• Large scale firings at USDA will jeopardize the delivery of USDA services that family farms depend on.

• Republican Congressional tentative plans to cut $150 billion from SNAP (Food Stamps) could also impact local markets for small farmers, as SNAP recipients are a higher percentage of rural communities than urban ones.

• Trump’s promise to deport millions of undocumented immigrants will worsen the farming sector’s chronic labor shortage, making it much more expensive or simply unobtainable.

• Under the Biden administration, the USDA, the Fair Trade Commission and the Dept of Justice launched far-ranging actions against Big Ag monopolies in poultry, meat-packing, pesticides, and ag equipment, all intended to reduce Big Ag’s monopoly power and give farmers fairer prices. This will almost certainly change under Trump. New FTC Chair Andrew Ferguson, for example, had opposed the Biden FTC’s action against John Deere for refusing to allow farmers to use independent repair shops.

• New USDA Secretary Rollins has signaled she supports the agro-industry’s demands for less oversight and a more lenient attitude towards corporate consolidation, which will place family farms at a disadvantage.

THE BOTTOM LINE: It is still early, and the Trump administration may yet face pressure from farm state Republicans to be more supportive of family farms. However, senior jobs in the administration are overwhelmingly filled by billionaires with little interest in agriculture, while Trump himself seems more intent on using draconian tariffs to promote manufacturing. The needs of American farmers thus far appear to be low on the priority list.

Rural Energy Costs

Trump administration policies appear likely to push up the total cost of energy (gasoline and electricity) for rural communities. This is because:

• Despite Trump’s election promise to increase oil production, oil producers were already pumping at record levels under Biden and have little extra capacity now.

• Yet Trump promises to push consumers away from electric vehicles by eliminating the EV tax credit and support for an EV charging network. The result: greater gasoline demand without extra supply would act to push up prices at the pump.

• Consumer electricity prices may well rise as well, possibly significantly, as Trump rolls back or repeals Biden’s energy-saving tax incentives, while simultaneously encouraging new data centers. This will lead electric utilities to build costly new capacity, costs that will likely be passed on to the consumer.

• At the same time, Trump has promised to reduce new solar and wind production, both commercial and residential. Although he has promised to increase new nuclear production, nuclear will not be a significant new contributor to energy independence in the next decade, given its long development timeframe.

THE BOTTOM LINE: Energy markets are of course global and that makes predicting the future challenging. However, energy prices are also a function of supply and demand. If Trump and the Republican Congress deliver on current plans to reduce total supply and increase total demand, than the price Americans will pay for both gasoline and electricity will likely go up. And rural communities are especially dependent upon energy for work and agricultural production.