NewsPoliticsHealth & FitnessMedicineGovernment

The Rural Impact

Michelle Rathman

A Podcast that Connects the Dots between Policy and Rural Everything.

Play

Open in

21 episodes
fortnightly
Avg 52 min
English

Episodes 21

Newest Oldest Longest

All20 Unplayed20 In progress0 Played0

Counted on this page — what you have heard stays on this device, so it is not something the list can be paged by.

Thursday · 41 min
The Other Side of Transformation with Leslie Dach
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.
August 13 · 35 min
Perspectives from Montana - Policy, Budget & Barriers to Care with Heather O'Loughlin
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.
July 30 · 1 hr 5 min
The Impact of H.R.1 One Year In with Alan Morgan, Jed Hansen, PhD, APRN, FNP-C, and Kait Guild
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.
July 16 · 41 min
A Conversation with Steven Conn | Lies of The Land
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.
July 2 · 45 min
Pathways to Powering Rural America with John C. Shepard
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
June 18 · 59 min
2026 Farm Bill, Protected Lands and Medicaid Landmines with Joan Alker and Heidi Heitkamp
In this power-hour conversation, Michelle begins by welcoming returning guest expert Joan Alker, Executive Director and Co-founder of the Center for Children and Families.  Joan shares recent research focused on understanding the impact of the increasing uninsured rate for young children and the two explore the significance of health insurance for children under six, including regular checkups and developmental screenings, trends in uninsured rates from 2022 to 2024, with a focus on the sharp increase among young children, the impact of Medicaid enrollment declines since 2025, including real-time data on a 2 million decrease in coverage, disparities in uninsured rates, emphasizing rural communities and racial/ethnic differences, the broader economic and social consequences of children losing health coverage, challenges posed by recent federal policy shifts, such as work reporting requirements and cuts affecting rural health providers. Breaking it down further, Joan provides specific state-level concerns, with Texas, North Dakota, and others showing notably high uninsured rates.  After a short break, Michelle welcomes back to the podcast former U.S. Senator from North Dakota, Heidi Heitkamp, and the two shift the conversation to discuss the progress of the 2026 Farm Bill, the importance of civic engagement, and the urgent need for transparent, bipartisan approaches to support farmers, rural communities, and land preservation. Heitkamp also discusses the rise in farm bankruptcies and economic challenges, Federal aid gaps and their impact on disaster recovery, the urgency of preserving public lands, and concerns about data centers and land-use conflicts.  The two end their conversation by discussing the importance of civic engagement and practical ways for rural constituents to participate in advocating for sound rural policy. Resources: https://ccf.georgetown.edu/2026/06/01/uninsurance-among-youngest-children-on-the-rise-as-families-face-growing-economic-pressure/ https://onecountryproject.com/about/
June 4 · 1 hr 10 min
Views from The Field: Farm Bill 2026 with Blaire Bryant, Dakkia Bradshaw and Bruno Sabatier
In this episode of The Rural Impact, Views from the Field: Farm Bill 2026, host Michelle Rathman speaks with Senior Legislative Director of the National Association of Counties Blaire Bryant and Commissioner Dakkia Bradshaw, from Telfair County Georgia, about the growing challenges facing rural communities as federal policies reshape healthcare and nutrition programs. Bryant outlines the realities of rural healthcare, including hospital closures, provider shortages, ambulance deserts, and financial pressures that threaten access to care. The discussion also explores how changes to Medicaid and the Rural Health Transformation Program may affect counties nationwide. Commissioner Bradshaw shares the perspective of a rural county leader working to improve healthcare access and broadband connectivity in her community. She explains why reliable internet service is essential for telehealth, remote patient monitoring, and attracting healthcare resources to underserved areas. Together, the guests discuss the future of SNAP benefits, the impact of food insecurity on community health, and the importance of ensuring rural voices are included in policy decisions that affect rural residents. In Part Two, Michelle is joined by Bruno Sabatier, Board Supervisor for Lake County, California, to examine how rural counties are responding to mounting pressures in healthcare, behavioral health, housing, and access to nutrition. Sabatier discusses the rise in mental health and substance use challenges since the pandemic, as well as the growing demand for food assistance programs and social services. The conversation explores how proposed changes to Medicaid and SNAP could impact rural residents and create additional administrative and financial burdens for counties already facing workforce shortages. Sabatier also highlights efforts underway in Lake County to address homelessness through transitional housing, veteran housing initiatives, and strong community partnerships. The episode concludes with a call for greater civic engagement, encouraging local leaders and residents alike to work together to advocate for policies that strengthen rural communities and improve quality of life.
May 21 · 16 min
Michelle's May Matters
In this solo Memorial Day and early summer episode of The Rural Impact, host Michelle Rathman shares reflections from the road while attending the National Rural Health Association Annual Meeting and previews several major policy conversations the podcast will continue exploring throughout 2026 and into 2027. Michelle discusses the expansion of the podcast’s “Tracking Transformation” series, examining rural health transformation funding, as well as upcoming conversations focused on the Farm Bill, federal education policy, election administration in rural counties, and how policy decisions continue shaping everyday life across rural America. The episode also explores concerns surrounding the rapid expansion of data centers in rural communities and the strain some projects are placing on local water resources. Michelle reflects on the importance of balancing technological growth with environmental stewardship while protecting public lands and access to clean water in rural regions. She also discusses ongoing concerns surrounding the United States Postal Service and the implications for rural communities that rely heavily on vote-by-mail systems and dependable postal infrastructure. Throughout the conversation, Michelle reinforces how policy decisions directly impact healthcare access, infrastructure, civic participation, and overall quality of life. A significant portion of the episode focuses on Medicaid work requirements and the potential consequences for rural healthcare systems. Michelle discusses Nebraska becoming the first state to implement Medicaid work requirements under H.R.1 and explains why healthcare experts believe many coverage losses will result from administrative reporting barriers rather than unemployment itself. Referencing lessons learned from Arkansas, she highlights how working individuals previously lost healthcare coverage because they were unable to successfully navigate reporting systems. Michelle closes the episode by reminding listeners that “all roads to quality of life are paved by policy” and encourages audiences to stay informed, engaged, and connected through future episodes of The Rural Impact and resources available at The Rural Impact.
May 7 · 1 hr 16 min
Tracking Transformation: Federal Funding Forecast and States' Use of RHTP Funds with Maya Sandalow, Chris Nelson and Carrie Cochran-McClain
In this episode of The Rural Impact, host Michelle Rathman continues the "Tracking Transformation" series with a closer look at how states are using Rural Health Transformation Program (RHTP) funding to modernize rural healthcare through technology. In part one, Michelle is joined by Maya Sandalow, Associate Director of the Bipartisan Policy Center, who discusses how investments in telehealth, remote patient monitoring, AI, and cybersecurity could reshape rural care delivery. Sandalow outlines key technology investment trends emerging from state RHTP plans and explains why infrastructure, implementation, and sustainability are critical to long-term transformation. In part two, federal health policy expert Chris Nelson joins Michelle to discuss how states, particularly those working with indigenous populations and Veterans health services, are prioritizing technology and workforce investments through their RHTP plans. Nelson also highlights barriers to technology adoption and the growing urgency surrounding maternal healthcare access in rural America. In the final segment, Michelle welcomes back Carrie Cochran-McClain, Chief Policy Officer for the National Rural Health Association, to discuss the policy landscape surrounding RHTP implementation. Carrie shares insight into the fast-moving rollout of funding and CMS accountability measures, as well as mounting concerns over looming Medicaid cuts and the financial pressures facing rural hospitals. Because we're all about connecting the dots, the conversation also covers maternal health service closures, broadband investments, the Administration's FY27 federal budget proposal, and the ongoing push to advance the Farm Bill and other key rural health priorities. RESOURCES: NRHA links: https://www.ruralhealth.us/nationalruralhealth/media/documents/advocacy/2026/fy-2027-approps-table-4-23-26.pdf https://www.ruralhealth.us/advocacy/advocacy-press-center/nrha-press-releases Report: Sustaining Rural Hospital Access https://bipartisanpolicy.org/report/sustaining-rural-hospital-access-adjustments-to-medicare-rural-hospital-designations/ https://www.linkedin.com/in/chris-nelson-566392274/
April 23 · 1 hr 1 min
The Precarious State of Public Education with Paige Shoemaker Demio and Dr. Steven L. Johnson
In part one of this episode, The Precarious State of Public Education, host Michelle Rathman continues the series on the state of rural education with policy expert Paige Shoemaker DeMio. Paige is a Senior Policy Analyst for K-12 Education Policy at the Center for American Progress (CAP). Before joining CAP, she served as a secondary social studies teacher in Cleveland. As a former educator, she has a passion for developing education policies that will ensure an equitable education system in the United States.  Paige and Michelle explore how school voucher programs and broader “school choice” policies are disproportionately harming rural communities. Drawing on research from states like West Virginia, Indiana, and Vermont, Paige explains how these programs often redirect public funds to families already enrolled in private schools, leaving rural public schools with fewer resources despite fixed costs and limited local funding capacity. The discussion also highlights how these funding shifts contribute to school closures, reduced programming, and long-term impacts on rural communities where schools serve as economic and social anchors. In part two, Dr. Steven L. Johnson, Superintendent in North Dakota, joins Michelle. Dr. Johnson is a member of the Executive Committee of the National Rural Education Association (NREA), where he co-chairs the Legislative Committee. With nearly 50 years in education, he has extensive experience in rural school leadership, policy, and district reorganization. During their conversation, Dr. Johnson shares a ground-level perspective on how federal policy shifts and Department of Education disruptions are affecting rural districts in real time. He describes the operational chaos caused by delayed funding, staffing cuts, and loss of institutional knowledge, emphasizing how even small disruptions can destabilize already fragile rural systems. The conversation broadens to include demographic decline, workforce challenges, and the importance of strategic adaptation, while also touching on interconnected issues like school meals and community sustainability. Dr. Johnson underscores the need for efficiency, direct funding, and practical solutions that prioritize students, reinforcing that rural schools must navigate uncertainty while remaining critical pillars of their communities.
April 9 · 1 hr 5 min
Rural Counties Responding to Policy Shifts: The Impact of Civic Engagement with Hope Harmon, Paul Heimel and Chuck Marohn Jr.
In part one of this episode of The Rural Impact, “Rural Counties Responding to Policy Shifts: The Impact of Civic Engagement,” Michelle speaks with two rural leaders navigating complex policy challenges: Commissioners Hope Harmon and Paul W. Heimel. Harmon, a County Commissioner in Ben Hill County, Georgia, champions education, healthcare, economic development, and public safety. Heimel, in his 19th year as a County Commissioner in Potter County, Pennsylvania, focuses on community and economic development amid population decline and an aging population, while also advancing work in criminal justice reform, healthcare, veterans’ affairs, and arts-driven revitalization. In Michelle’s conversation with Commissioners Harmon and Heimel, they explore the growing strain federal policy shifts are placing on rural counties, from reduced funding and rising service costs to workforce shortages, healthcare access challenges, and population decline. Both Commissioners share firsthand insights into how their communities are adapting through budget tightening, restructuring services, and emphasizing the importance of civic engagement. They highlight the critical role of community involvement, local leadership, and innovative approaches, such as partnerships, grassroots events, and arts initiatives, in sustaining and strengthening rural communities despite limited resources. In the second part of the episode, Michelle is joined by Charles “Chuck” Marohn Jr., Founder and President of Strong Towns, an organization focused on helping communities build financial resilience and long-term sustainability through bottom-up development strategies. In his segment, Chuck and Michelle discuss how traditional top-down economic development models have contributed to financial fragility in rural communities. He emphasizes the need for incremental, locally driven growth, smarter infrastructure investment, and rethinking housing and development patterns to better align with the realities of small towns. He also underscores the importance of focusing on local action, encouraging individuals to engage in their communities, rebuild civic infrastructure, and take practical steps to create stronger, more resilient places to live. GUESTS: Hope Harmon, Ben Hill County Commissioner Paul W. Heimel, Potter County Commissioner Charles “Chuck” Marohn, Jr, Founder and President of Strong Towns
March 26 · 43 min
USPS Under Threat and the Impact on Rural with Elena Patel and Sarah Anderson
In part one of this episode, USPS Under Threat and the Impact on Rural America, Elena Patel, Co-Director of the Urban-Brookings Tax Policy Center, joins Michelle to break down the growing financial crisis facing the United States Postal Service. Elena shares insights from her recent research on the USPS funding model, explaining how the shift from letter mail to digital communication has disrupted a system that once sustained universal service. The conversation explores the Postal Service’s Universal Service Obligation and what it means to deliver affordable mail service to every address in the country, six days a week. They discuss the structural challenges USPS faces, including rising operational costs, limited borrowing authority, and increasing competition in package delivery. Elena also outlines potential policy solutions, emphasizing the critical role Congress must play in modernizing funding mechanisms to reflect today’s digital economy. The conversation highlights the broader implications for rural communities, small businesses, and essential services that rely on a stable and accessible postal system. In part two of this episode, Sarah Anderson, Global Economy Director at the Institute for Policy Studies, joins Michelle to explore the deeper community impact of the Postal Service, particularly in rural America. The conversation examines how USPS functions as more than a delivery system, serving as a vital economic and social lifeline for rural residents. Sarah discusses the potential consequences of privatization, including increased costs, reduced service, and the possible closure of rural post offices. They also highlight the essential role USPS plays in delivering prescription medications, supporting small businesses, and ensuring access to vote-by-mail, especially in areas with limited polling locations. The discussion addresses workforce impacts, noting the importance of postal jobs as stable, middle-class employment in rural communities. Looking ahead, Sarah shares ideas for strengthening the Postal Service through expanded services, such as financial offerings and community-based programs, while reinforcing the importance of preserving USPS as a public good that serves all Americans.
March 12 · 47 min
Rural Education: Public Funds for Private Schools with Dr. Melissa Sadorf and Jessica Piper
In part one of this episode, Rural Education: Public Funds for Private Schools, Dr. Melissa Sadorf, Executive Director of the National Rural Education Association (NREA), joins Michelle to discuss the evolving landscape of rural education. Dr. Sadorf shares insights from the 2022-2027 NREA research agenda, highlighting the importance of spatial and educational equity and how policy decisions shape students' and communities' opportunities. The conversation continues to focus on persistent and new challenges facing rural education systems and schools, including student funding disparities, teacher recruitment and retention, and limited broadband access that can restrict learning opportunities for those seeking to access virtual charter schools. Moving to Policy Lifts and Let Downs - Dr. Sadorf describes the impact of the 2025 dismantling of the U.S. Department of Education's Office of English Language Acquisition (OELA) and the expanding, critical role of rural schools as hubs for health and wellness services. The two also discuss the lift rural schools are receiving from an innovative program funded by a U.S. Environmental Protection Agency grant. Before a break, Michelle and Dr. Sadoff discuss the complexities of school choice in rural areas, and looking ahead, Dr. Sadoff outlines key priorities for future research and policy advocacy to strengthen rural education systems and the communities they serve. In part two of this episode, Executive Director of Blue Missouri, Jessica "Jess" Piper, returns to Rural Impact to take a closer look at the challenges and resilience of rural education in Missouri. The conversation examines how decades of public education underfunding impact rural districts, including contributing to larger class sizes, fewer resources, and increased pressure on educators. They also discuss efforts to expand school privatization and voucher programs that use public funds for religion-centered education, as well as how school-choice policies in Missouri are expanding, and what it could mean for public schools, including the quality of education K-12 students have access to and the economic impact on rural communities when choice creates fewer options for funding public education.
February 26 · 42 min
Tracking Transformation: Opportunity for Some, for Others Pain with Joan Alker, Dr. Shannon Dowler, Alan Morgan and Carrie Henning-Smith, PhD, MPH, MSW
In part one of this episode, Tracking Transformation: Opportunity for Some, for Others Pain, Michelle sits down with Executive Director and Co-Founder of the Center for Children and Families at the Georgetown University McCourt School of Public Policy, Joan Alker, as well as Dr. Shannon Dowler, who is a family medicine physician, serves on the Board of Directors for the American Academy of Family Physicians, and an expert leader in Medicaid programs and expansion. Michelle, Joan, and Dr. Dowler unpack the scale and scope of recent Medicaid cuts under H.R. 1, examining how nearly $1 trillion in reductions compare with investments in rural health and what that imbalance means for communities on the ground. They explore the disproportionate impact on rural populations and how these cuts intensify existing racial, economic, and geographic health disparities. The conversation breaks down the political landscape, separating rhetoric from the reality of rural health funding, and explains the mechanics of provider taxes, state-level Medicaid financing strategies, and how work requirements contribute to coverage churn. Finally, they highlight actionable strategies for healthcare providers and advocates to educate policymakers and the public, underscoring the urgent need to reverse federal Medicaid cuts and protect essential rural health services. At the close of the episode, Michelle shares some special excerpts from interviews she had while attending the National Rural Health Association (NRHA) Policy Institute, with NRHA CEO Alan Morgan and President Carrie Henning-Smith. Alan Morgan argues that the “slowing of growth” in Medicaid is effectively a cut that will harm rural hospitals, which are already struggling due to a high concentration of patients with complex health needs and limited ability to pay, not because of low volume or poor management. He emphasizes that Medicaid is the primary tool keeping rural hospitals open by helping offset uncompensated care and bad debt, and he urges postponing the proposed reductions. Dr. Carrie Henning-Smith adds that rural health policy must focus on strengthening the overall foundation of care, addressing longstanding disparities, stopping looming Medicaid cuts, reinforcing the safety net, investing in the workforce, and making temporary support programs permanent through statutory action.
February 12 · 50 min
The Inescapable Impact of Immigration Policies on Small Towns and Rural Communities with Lynn Melling, Brian Depew and Betsy Froiland
In part one of this episode, The Inescapable Impact of Immigration Policies on Small Towns and Rural Communities, Michelle sits down with Emmy and Murrow Award–winning video storyteller, content strategist, and co-founder of 515 Productions, Lynn Melling, to examine how immigration policies and ICE operations are shaping life in small rural communities like Melrose, Minnesota. Lynn shares insights into the cultural, economic, and emotional impacts on residents, local businesses, law enforcement, and emergency services, and discusses how fear and silence often limit open community dialogue. The conversation underscores the critical role of storytelling and local journalism in bringing empathy, accuracy, and rural voices into the national immigration conversation. In part two, Brian Depew, Executive Director of the Center for Rural Affairs, and Michelle explore how federal immigration policies are affecting rural communities across the country. They discuss the fear these policies create for immigrant workers, the resulting workforce shortages in sectors such as agriculture and healthcare, and the essential role immigrants play in sustaining rural economies. Brian also highlights growing bipartisan support for reform and the power of public advocacy to drive meaningful immigration policy change. In part three, Michelle speaks with Betsy Froiland, a freelance reporter whose work focuses on rural faith communities and social issues, featured in The Daily Yonder, Barn Raiser, and MinnPost. Betsy shares reporting from Willmar, Minnesota, examining the personal and economic consequences of immigration enforcement in rural communities. The conversation explores fear stemming from ICE actions, ripple effects on families, schools, and local businesses, and the resilience and solidarity that emerge in response. The episode concludes with a discussion on the vital role of independent journalism and the need for policy change to better protect vulnerable populations. Resources: "Melrose" https://youtu.be/TVmNbIEXOc0?si=4mmydoK1yVFT7nx8 Federal immigration actions affect rural communities, too https://www.cfra.org/blog/federal-immigration-actions-affect-rural-communities-too\ "A Small Town Under ICE Occupation" https://dailyyonder.com/a-small-town-under-ice-occupation/2026/02/02/
January 29 · 48 min
Great Healthcare Plan & Threats to Food Security with Larry Levitt & Gina Plata-Nino
In part one of the episode, Tracking Transformation: Great Healthcare Plan & Threats to Food Security, Larry Levitt, Executive Vice President for Health Policy at KFF, joins host Michelle Rathman. Larry oversees KFF's policy work on Medicare, Medicaid, the health care marketplace, the Affordable Care Act, racial equity, women's health, and global health. In this conversation, Michelle and Larry Levitt discuss the current state of health policy in America, focusing on President Trump's recent healthcare plan, affordability challenges, and implications for rural health. They explore the complexities of healthcare funding, the impact of the ACA, and the potential effects of the Rural Health Transformation Fund. The discussion highlights the need for transparency and bipartisan cooperation in addressing these pressing issues. In the second half of this in-depth episode, Michelle speaks with Gina Plata-Nino, SNAP Director for the Food Research & Action Center (FRAC). At FRAC, Gina collaborates with the SNAP team to expand the program's reach and improve its effectiveness for low-income households. She leads legislative and technical support efforts for national, state, and community organizations, as well as government agencies and nonprofits, to strengthen SNAP access, benefits, and customer service. Michelle and Gina discuss the critical intersection of agriculture, nutrition, and policy, with a particular focus on the Supplemental Nutrition Assistance Program (SNAP). They delve into the implications of recent legislative proposals that threaten to undermine SNAP, highlighting the hardships they could cause for millions of Americans, especially in rural areas. Gina emphasizes the economic ripple effects of these policies, explaining how cuts to SNAP could lead to significant losses for farmers and local economies, exacerbating food insecurity and health disparities. The conversation also addresses the broader implications of federal disinvestment in rural communities, including the strain on state budgets and the potential for increased poverty and food deserts. Gina articulates the urgent need for policy changes that prioritize access to healthy food and support for local economies. The episode concludes with a call to action for listeners to engage with their legislators to advocate for better SNAP policies that ensure food security and health equity for all communities. Rural Impact Merchandise Has Arrived! Visit our Store and Order Your Gear Show Resources: https://frac.org/action https://www.kff.org/
January 15 · 58 min
Tracking Transformation: Funding Awarded. Now What? with Bob Atlas and Kevin Bennett
In part one of the episode, Tracking Transformation: Funding Awarded. Now What? Michelle Rathman invites Grace Creek Advisors' Bob Atlas to discuss his analysis of the Rural Health Transformation Program (RHTP). Bob is an executive consultant in health policy and strategy, serving public - and private - sector clients nationwide on health care delivery and financing. The health care safety net is a special focus of his work. In their discussion, Michelle and Bob focus on the implications of the $50 billion funding aimed at addressing the challenges faced by rural healthcare systems. They explore the limitations of the funding, the importance of workforce resilience, the need for transparency in allocation, and the critical role of advocacy in ensuring effective use of resources. The discussion highlights the interconnectedness of rural and urban health systems and the necessity for a comprehensive approach to healthcare transformation. In the second half of this in - depth episode, Michelle speaks with Kevin Bennett, PhD. Bennett is a Professor of Family & Preventive Medicine at the University of South Carolina School of Medicine in Columbia, SC. He serves as the Director of the South Carolina Center for Rural and Primary Healthcare. He served as the president of the National Rural Health Association in 2024. His work focuses on improving healthcare delivery for marginalized and underserved communities, particularly in rural areas, while examining the influence of national, state, or local policies and legislation on these populations. The conversation delves into RHTP, discussing its strategic goals, implementation logistics, how it may address workforce challenges, and the importance of empowering rural communities, including cross - sector leaders, to become involved in how funds are invested to ensure they are used for transformation rather than "new toys." The dialogue emphasizes the need for sustainable access to healthcare, innovative care models, and the role of technology, while also addressing the cautious optimism surrounding the program's potential impact on rural health systems. Resources: Rural Health Transformation Program: Analysis of Funding By State
January 1 · 1 hr 21 min
Making Waves Meeting People Where They Are
Every year, National Rural Health Day is a chance to recognize and celebrate the dedicated efforts of rural health advocates and partners working to improve rural life. On November 20, 2025, The Rural Impact celebrated with something special, a live, story-driven event that lifted the voices behind The Rural Effect. Over the past two years, over a dozen Community-Based Organizations across Massachusetts led bold, creative, community-rooted work that rippled across 143 rural towns, resulting in expanded access, stronger trust, and lasting local change. Rural Impact Host and Creator, as well as Rural Effect producer and storyteller, Michelle Rathman, brought together rural leaders who expanded access, belonging, and opportunity, along with staff from community benefit organizations reaching the most remote corners of the state, and leaders from the New England Rural Health Association advancing rural health equity, to share their stories in a special livestream event. As we kick off a new year with a keen focus on tracking rural health transformation and other policies that impact over 60 million people, we invite you to listen to this special episode. Every conversation offered something valuable, insight, hope, inspiration, and a reminder that rural communities hold extraordinary potential, and indeed are the #powerofrural. Special thanks to Kirby Lecy, Jennifer Kimball, Ezekiel Baskin, Sarah Garvin, and Brea Corsaro.
Dec 18, 2025 · 1 hr 11 min
Uncertain Times for Community Health Centers with Dr. Feygele Jacobs and Joe Dunn
In part one of the last episode of 2025, 'Uncertain Times for Community Health Centers,' Michelle invites Feygele Jacobs, DrPH, MS, MPH to The Rural Impact. Dr. Jacobs is the Director of the Geiger Gibson Program in Community Health and Professor of Health Policy and Management at the Milken Institute School of Public Health, George Washington University. Previously, she was President and CEO of the RCHN Community Health Foundation, a non-profit dedicated exclusively to supporting and benefiting health centers and their communities and patients. Her diverse background includes positions in Medicaid managed care, public health care systems, and teaching hospitals. Summary Michelle Rathman speaks with Dr. Jacobs about the critical role of community health centers in the American healthcare system, especially in light of recent legislative changes such as HR1. They discuss the challenges these centers face, including funding cuts, Medicaid work requirements, and the impact of immigration policies on access to care. The conversation highlights the importance of these centers in serving vulnerable populations and the potential consequences of policy changes on healthcare access and quality. In part two of this episode, Michelle talks with National Association of Community Health Centers Chief Policy Officer, Joe Dunn. Joe is a two-time graduate of the George Washington University, Joe has spent the last twenty years in Washington, DC, on Capitol Hill and in a variety of government relations roles. Joe joined NACHC in January 2021 as Senior Vice President for Public Policy and Research from Cigna. Prior to this, he was in senior positions in three congressional offices, including Connecticut Senator Chris Murphy. Michelle and Joe discuss the critical role of community health centers in rural America, highlighting their contributions over the past 60 years, the challenges they face, and the importance of advocacy. They delve into the Rural Health Transformation Fund, workforce shortages, funding instability, and the need for innovative solutions to overcome geographic isolation. The discussion emphasizes the significance of community voices in shaping health policy and ensuring the sustainability of these vital health services.
Dec 4, 2025 · 48 min
A Conversation about the Intersections of Policy and Philanthropy with Cara V. James, PhD
In this episode, 'A Conversation About the Intersections of Policy and Philanthropy,' Cara V. James, PhD, President and CEO of Grantmakers in Health (GIH), joins Michelle to explore key topics like rural health funding challenges and the critical conversations shaping health policy. Before joining GIH in 2020, James served as Director of the Office of Minority Health at the Centers for Medicare & Medicaid Services (CMS) in the US Department of Health and Human Services, where she provided leadership, vision, and direction to advance health equity. Under her guidance, CMS developed its first CMS Equity Plan to Improve Quality in Medicare, its first Rural Health Strategy, created an ongoing initiative to help individuals understand their coverage and connect to care, increased the collection and reporting of demographic data, and developed numerous tools and resources to advance health equity. In this conversation, Michelle and Cara talk candidly about how philanthropy can address health disparities, especially in rural communities, and the impact of government policies on nonprofit funding, emphasizing community engagement and leadership in advancing health equity. The conversation highlights the need for a collaborative approach to improve healthcare access and population health, stressing the importance of systemic change and the freedom to give, encouraging listeners to consider how they can support these efforts.

Showing 1–20 of 21 episodes