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Leaders and policymakers have worked hard to address lagging rural healthcare statistics, making progress. However, a persistent gap in rural-urban healthcare remains. Rural residents experience more severe injuries per capita than their urban and suburban peers and also face a risk of injury-related death that is more than 20 percent greater compared to people living in urban areas. Chronic conditions and preventable diseases — like cancer, heart disease and stroke — are more common, while crucial access to specialists and follow-up care is harder to come by.

Many rural families lack access to employer-based healthcare benefits. Even with tax credits, private insurance remains out of reach for small-business owners, agricultural workers, heavy machinery laborers, and temporary or freelance workers. These people keep our economy churning.

In family-run businesses, every penny is precious, and dollars must stretch further. Sometimes, essential needs such as health insurance do not fit in the budget, leading to greater financial danger should an illness or injury occur.

This isn’t unique. Fewer than half of farming, fishing and forestry workers are eligible for employer-sponsored health insurance, and Medicaid helps fill that gap.

The Medicaid program is essential in rural America. Coverage provides critical support that rural healthcare and economies cannot do without. For instance, Medicaid covers nearly half of all children under age 19 in our country who live outside metropolitan areas, where almost one in five children lives in poverty.

Medicaid isn’t just a safety net for rural citizens and families; it is also a critical revenue source that keeps rural hospitals afloat, ensuring that all patients, regardless of their type of coverage or lack thereof, can rely on them.

Nearly 200 rural hospitals nationwide have been forced to cut back services — or close their doors entirely — due to rising costs, supply chain disruptions and staffing shortages. Of the rural hospitals that remain open, one in three is at high risk of closure, while more than 90 percent of rural counties are already experiencing healthcare worker shortages.

Now, Congress is considering a budget that contains significant cuts to Medicaid funding. The nonpartisan Congressional Budget Office warns that these proposed cuts could result in massive coverage losses, taking healthcare access away from millions of rural residents. This would exacerbate the already significant issues in rural healthcare, widening the inequitable and inexcusable health gap.

The fallout in rural America would be catastrophic. Rural patients would face further distances to access a doctor or specialist, longer wait times for appointments, and frequent disruptions to care. The consequences of facility closures and layoffs would trigger a domino effect, devastating local economies and pushing vulnerable, struggling families closer to the edge.

Every American — regardless of their ZIP code — deserves the dignity of timely, affordable healthcare. Medicaid makes that possible for millions in rural communities. Congress must reject these dangerous cuts and stand with the hardworking families who feed, fuel and serve as the backbone of this country. Our rural future — and the future of all of America — depends on it.