Lawmakers and health groups pushback on Rural Health Transformation Program plans and limits

Nebraska State Capitol in Lincoln
(Photo by Pieter van de Sande, Unsplash)

The excitement and energy that was first attached to millions of federal dollars in awards to states for the Rural Health Transformation Program has already started to fade. Some legislatures and health groups are resisting their state's proposals and pushing for more input on how the money is spent, report Arielle Zionts and Sarah Jane Tribble of KFF Health News.

The awards, which are funded through the Centers for Medicare & Medicaid Services, impose strict timelines and rules on the use and implementation of millions of dollars. Lawmakers, who must work quickly to pass bills needed to use the funds, and rural health groups are finding themselves at odds with award restrictions.

Much of the disconnect stems from what many lawmakers thought they could use RHTP money for, based on how the program was marketed, versus what CMS will allow.

The White House promoted RHTP awards as a way to "shore up rural health care," but their use isn't aimed at saving struggling rural hospitals. Instead, the funds are to be used for "seeding innovative projects and technologies," Zionts and Tribble explain. "States can use only up to 15% of their funding to pay providers for patient care."

Some state Republican lawmakers — especially those representing more rural regions — as well as rural hospital advocates, "are upset that the political rhetoric doesn’t match what they see," KFF reports. "They’re also lobbing criticisms at specific aspects of their states’ plans, including the proposed projects, what’s not included, and the spending approval process."

State lawmakers from Wyoming, Ohio, North Dakota, Michigan, North Carolina, Nebraska and Colorado all face conflicts and competing needs to get the work done so their states can spend the money and then decide who gets it, KFF reports.

Jed Hansen, executive director of the Nebraska Rural Health Association, told KFF, "Rural Health Transformation will not save a single hospital in our state. I don’t think it will save a hospital nationally.”

Rural towns provide land, workforce and a unique energy supply to support a new type of nuclear power plant

The Natrium facility divides nuclear and nonnuclear sections of the plant, which leads to more
reliable energy output at lower cost. (TerraPower design graphic)

TerraPower plans to build smaller nuclear power plants in declining coal towns across the U.S., and it needs land, a reliable workforce, and a uniquely enriched uranium to get the job done. Rural towns more than 1,500 miles apart will provide all three for the first reactor.

Kemmerer, Wyoming, is providing the site, many of the workers, and infrastructure supports for TerraPower's first power plant, called Natrium, which recently became "the first new commercial reactor to receive federal approval in nearly a decade," reports Brad Plumer for The New York Times.

The federal permit allows the company to begin construction on Natrium's nuclear components. "The company had already broken ground on the site in 2024 and had begun building the non-nuclear parts of the plant," Plumer explains. Natrium is slated to go online in 2031, just a couple of years before the town's coal plant is expected to be retired.

The plant's designs are novel and will allow smaller, less expensive reactors to be built; however, when the company broke ground on its Kemmerer plant, it didn't have an American supplier for the reactor's unique enriched Uranium known as HALEU.

At the time, only Russia was making HALEU. As TerraPower searched for a solution, a uranium enrichment facility in the rural town of Piketon, Ohio, said it could step up to produce HALEU before the reactor went online.

TerraPower is now "partnering through a memorandum of understanding with Centrus, a company in Ohio, that will likely be the first in the U.S. to make the fuel on a commercial scale," reports of Caitlin Tan of Wyoming Public Radio. 

Virtual Crisis Care connects rural law enforcement with mental health resources during emergencies

Virtual Crisis Care programs, expanding from South Dakota into Wyoming, are helping law enforcement in rural communities gain on-demand access to mental health professionals to de-escalate emergency situations, reports Madeline de Figueiredo for The Daily Yonder.

Officers connect with the telemedicine network Avel eCare in real-time, effectively helping about 80% of individuals across the country to receive care safely at home rather than being unnecessarily hospitalized or incarcerated, Figueiredo explains.

A clinician from Avel eCare specifically assigned to an individual “conducts a risk evaluation, creates a safety plan, and works with officers on next steps,” Figueiredo reports. Because Virtual Crisis Care isn’t just for an emergency response, these next steps always include connecting the individuals with local community health centers for follow-up care.

This program, funded by the Helmsley Charitable Trust, has been used in South Dakota for over five years by more than 30 rural law enforcement departments. Last year, the program was introduced to the Wyoming Association of Sheriffs and Chiefs of Police (WASCOP), with about 25% of law enforcement agencies participating so far.

“I think if you look at serving in rural America, not only on the criminal side but on the mental health side, you deal with the same people over years and decades. If you can get someone struggling with addiction or mental health into treatment and help them change their life, then we’re not seeing them anymore on the law enforcement side of things,” the executive director of WASCOP, Allen Thompson, told Figueiredo.

Study: More Americans ages 18-54 are dying from severe first heart attacks

Even some 35-year-olds are at risk for severe heart
attacks. (Photo by E. Akurt, Unsplash)

Death by heart attack used to be a worry for only older Americans, but a new study revealed an alarming increase in heart attack deaths among younger Americans. The results are particularly worrisome for younger rural Americans who tend to have less access to preventative medical treatment, are more likely to smoke cigarettes and often face longer drives to reach emergency care. 

"The proportion of adults ages 18 to 54 who died in a hospital of a severe first heart attack rose 57% between 2011 and 2022, according to the study published in the Journal of the American Heart Association," reports Betsy McKay of The Wall Street Journal. The study data showed that more than 75% of severe heart attack deaths were men, and 71% were between the ages of 45 and 54 years.

The increase in heart attacks deaths is yet another indicator younger Americans aren't as healthy as previous generations. McKay writes, "Poorer health among younger adults is one reason heart disease remains the leading cause of death in the U.S."

Americans who died after a heart attack often had other underlying chronic health issues or smoked. "About 60% had high blood pressure, while more than half also had high cholesterol and smoked. About a quarter had diabetes."

Younger adults need to be warned that the risk of heart attacks can begin "as early as age 35," McKay adds. "Younger people could use a risk calculator on the AHA’s website." Experts recommend using the 30-year estimate rather than a 10-year one for greater accuracy.

A 'Mafia' outfit centered on growing more American oats

Oats used by most American cereal brands are sourced from
Canada. (Graphic by Adam Dixon, Offrange)

Over the past several decades, the acres of oats American farmers have produced have dipped dramatically. The USDA doesn't heavily subsidize oat crops like it does corn and soybeans, and most oats used in the U.S. are sourced from Canada. However, a "growing group of more than 100 Midwestern farmers is trying to bring it back," reports Aimee Rawlins for Offrange.

Back in 2018, Martin Larsen, a fifth-generation farmer in Minnesota, looked at his crops and thought oats would be good for his soil, and the rising popularity of oat milk could help his bottom line, Rawlins writes.

Larsen convinced other Minnesota farmers to add oats to their rotation. The group struggled to find mills and break into the supply chain. Rawlings writes, "But Larsen and his fellow farmers weren’t deterred. Instead, they coined a name for their group: the Oat Mafia. They decided to create a supply chain — and, eventually, a mill — of their own."

Part of the reason Oat Mafia farmers have persisted is that oat crops do soil systems a world of good, including removing nitrogen that "might otherwise leach into groundwater," Rawlings explains. "And when added to a corn-soy rotation, oats help break pest cycles, reduce disease pressure, and curb resistant weeds." Oats also thrive during severe droughts.

The group's persistence has paid off. "Today, the Oat Mafia has around 125 farmers with 50,000 acres of tillable land and about 6,000 acres of oats, said Larsen, who started with just seven acres and now grows 500," Rawlings writes.

The group is investing in building their own mill to avoid milling entanglements, and Larsen is spending more time promoting oats to other farmers as a financially manageable addition to crop rotations. Rawlings reports, "He aims to be a resource for other farmers who aren’t sure where to start, offering advice on everything from what varieties to plant and how many oats per acre, to how much fertilizer to use and how to combine them."

Quick hits: E15 'Stop the Stall' campaign; popcorn history; Connecticut's bid to attract first responders; Tolkien for men

Rural Voices USA photo

When the congressional Rural Domestic Energy Council failed to meet its Feb. 15 deadline to pass year-round E15 legislation, Rural Voices USA began targeted billboard campaigns in Iowa, Michigan, Minnesota, Nebraska and Wisconsin. WisPolitics-State Affairs reports, "The billboards, part of a six-figure multi-channel pressure campaign, are now live on digital boards. . . .The campaign targets districts represented by Republican champions of E15 legislation who have been unable to move the bill through congressional leadership." Allowing E15 year-round would help corn farmers secure a reliable, domestic income that isn't subject to export volatility.

March has arrived, but in many parts of the U.S., the snow hasn't left. In fact, there are still piles and piles of it everywhere. Victoria Hoffmann of the Christian Science Monitor wondered where a city like Boston, which received more than 5 feet of snow this winter, put all their snow. The answer: Snow farms. "My search led me on a journey to places in Boston I’ve never ventured before. Boston is operating 14 snow farms this year, the first time in years that a mayor ordered that many to be opened."

At first, U.S. movie theaters didn't want to sell 'the noisy
snack.' (Photo by M. Ingvordsen, Unsplash)

Heading to the movies didn't always include a bucket of popcorn. "At first, theater owners wanted nothing to do with the noisy snack. But then came the Great Depression," reports Heidi Mitchell of The Wall Street Journal. "The appeal was obvious: It was cheap, fast and theatrical. Families popped it over wood stoves; peddlers sold it in paper cones at circuses. . . .A whiff of fresh corn could draw a crowd quicker than any barker’s repetitive shout." Read about popcorn's history in the U.S. here.

In a bid to attract more first responders, Connecticut plans to offer recruits a range of incentives. Gov. Ned Lamont's bill, H.B. 5046, "would waive tuition to the state’s public colleges and universities for people who have worked as police officers for at least five years and for people who have served as paid or volunteer firefighters for at least five years," reports Emilia Otte of the CT Mirror. "The bill also authorizes the Connecticut Housing Finance Authority to create a mortgage assistance program for police officers and firefighters."

J.R.R. Tolkien's Lord of the Rings trilogy has taken millions of readers on what is arguably the most epic rural adventure -- to Mordor and back again. And while the tales of Bilbo and Frodo remain strikingly popular, they continue to have a more dramatic appeal for men. "Both Tolkien’s cosmic vision of Middle-earth and the many genuine heroes that populate his work likely make for an attractive combination in the eyes of many a meaning-starved young man," writes Peter Biles for The Dispatch. "As I wrote for The Dispatch a few months ago, boys don’t just automatically become good men in a vacuum; they need role models. Manhood must be carefully nurtured. . ."

The Great Florida Cattle Drive celebrates the Sunshine State's ranching heritage.
(Great Florida Cattle Drive photo)

When it comes to cowboys and cattle, most Americans tend to think of the West, but in early America, Florida was where the cattle and the cowboys traveled together. In a tribute to the state's history, "nearly 300 people and 300 head of cattle traveled a century back in time for the 5th iteration of the Great Florida Cattle Drive," reports Isaac Eger for National Geographic. Over six days and six nights the drive became "a living history reenactment where hundreds of riders on horseback walk, trot, canter, and gallop through 54 miles of pristine Florida country that is now part of the Florida Wildlife Corridor." Read about their adventure here.

U.S. farmers skew Republican, but many are drawing the line at land and energy hogging data centers

Some U.S. farmers in red states are vocally opposing 
data center project proposals. (Adobe Stock photo)

Land-hungry data center developers and AI supporters, such as President Donald Trump, have run into a roadblock that may be hard to circumvent: American farmers in deep-red states are actively opposing data center projects in their communities.

"The tech industry’s relentless push for data centers is colliding with farmers who see the projects as a threat to their way of life, fueling unrest in Republican primaries and vocal criticism from conservative candidates," reports Rachel Shin of Politico.

Texas Agriculture Commissioner Sid Miller, who is running for reelection, doesn't see any benefit to farmers from unregulated data center builds. He told Shin, “There’s no guardrails of any kind. . . .So they can pop up wherever they want to, as often as they want to, and take up as much land as they want to.”

"Miller recently proposed creating 'agriculture freedom zones' that would use federal or state tax incentives to push data center development away from agricultural land," Shin explains.

Even as Trump insists his "AI dominance" agenda will benefit rural communities, most Americans, including rural residents, don't want to live near a data center project. Shin reports, "A recent poll from Politico and Public First found [data center project] support  falls to roughly 36% if the data center is being built in their local area, within 3 miles of where they live."

Other politicians are searching for a way to limit data center projects while maintaining the president's support. Shin reports, "Pennsylvania’s Democratic Gov. Josh Shapiro, who has expressed support for data center projects, and Florida’s Republican Gov. Ron DeSantis both floated placing guardrails on Trump’s AI initiative."

Karen Dalton, who is "one of three Republicans primarying Rep. Scott Perry (R-Pa.), told Shin, "We’re taking farmland that could be used to grow food, and we’re making it available to data centers. I think that’s short-sighted. We should be more focused on our farmers that are already hurting because of the tariffs.”

Brown tap water and an ongoing boil order highlights water systems under stress in rural towns

Brown water from a Tallulah residential tap.
(Photo by Donald Wood via WWNO)

In Tallulah, Louisiana and Cotton Plant, Arkansas, there's plenty of drinking water, but it runs brown from residential faucets and leaves stains on most things it touches.

Both small towns have sunk into debt paying for repairs to their aging water infrastructure. Despite those efforts, most Tallulah and Cotton Plant residents still face brown water in their taps, report Elise Plunk, Lucas Dufalla and Phillip Powell for New Orleans Public Radio, WWNO.

The water problems in both towns aren't isolated issues. Of the more than 45,000 community water systems that serve 10,000 people or less, "more than a third fell out of compliance with federal water standards sometime in the 12-month period that ended last September," WWNO reports. "For many of the 66 million Americans who live in rural places, [those systems] are the main source of water."

Tallulah used to be a vibrant town, but over time, its population dwindled, shrinking municipal tax revenue needed to repair aging water systems. Tallulah owned its water system and used its income to cover the rest of the town's needs, rather than investing in water system upgrades and repairs.

Some Tallulah residents purchased expensive filtering equipment, but even that hasn't been a full solution because the poor water quality breaks the filters.

Cotton Plant, Arkansas, residents have been dealing with "a boil order since last year, with little hope of securing the funds needed to fix an aging water system that is drowning in debt," Plunk writes. "The town’s water struggles started in 2023 and worsened in 2025, after a break in one of the main water lines sent discolored water rushing through residents’ taps."

Cotton Plant was a bustling agricultural town with 1,800 residents at its peak in 1950. According to WWNO, the town's water system is now too large and too expensive to be maintained by Cotton Plant's ever-shrinking population, which hovers at 530 people. Without tax revenue to address water system needs, the town borrowed money from the Arkansas Department of Agriculture and the USDA. Cotton Plant's water is still undrinkable.

This story was produced by the Mississippi River Basin Ag & Water Desk, an independent reporting network based at the University of Missouri, in partnership with Report for America.

20% of beef purchases today are from "beef-on-dairy" cattle

Roughly 20% of beef purchased by U.S. consumers is from
beef-on-dairy cattle. (Photo by Austin Santaniello, Unsplash)

Many Americans may not know that about 20% of their beef today comes from beef-on-dairy cattle, Taylor Leach reports for Dairy Herd Management.

Beef-on-dairy, which originates from female dairy cattle being bred to male beef cattle, has allowed for improved, higher-quality calves that benefit the dairy, beef and consumer sectors, Leach explains.

While beef-on-dairy started out as just a mechanism for reproduction in dairy cattle, Leach reports, the genetic advantages have proven to aid in the beef industry long-term, causing farmers to be more intentional with their sire selection.

Three of the major genetic improvements found to make beef-on-dairy better resemble native beef cattle include “fertility and calving traits for dairies, feed efficiency and growth traits for feedyards, carcass merit and consistency traits for the packers," Leach reports.

Not only is beef-on-dairy a better process for farmers, but the beef has proven to be good for consumers as well. Over the past five years, Matthew Cleveland of ABS Global told Leach, the quality grade has continuously improved. “Back in 2021, these animals graded 80% Choice or better. Today they’re leveling at about 92% Choice.”

Nick Hardcastle of Cargill North America similarly told Leach that from a marbling perspective, about two-thirds of beef-on-dairy cattle could qualify for upper two-thirds Choice. He also said they’re “grading well, adding stability to supply and proving they can hold their own in a system that demands both consistency and performance.”

The 'quintessential institution,' the American tavern, makes a comeback

The Stissing House embraces the 'building’s history as a tavern as far back as the 18th century.'
(The Stissing House photo)

American taverns have been part of the country's social weave since early colonial times, sometimes tucked into the cozy basement of a town-square quilting shop or casting warmth onto a darkening street next to the town bakery. But after decades of popularity, the appeal of the American tavern began to fade, until more recently, when chefs and locals began reviving the meeting place for a bit of company, good food and a relaxing pint.

"Across the country, chefs are abandoning the Sisyphean task of running high-end big city restaurants and returning to why — and what — they started cooking," reports Joshua David Stein of The Wall Street Journal. Taverns, which live in a space that's neither bar nor restaurant, are "one of the country’s most quintessential institutions. . . . a 'third place' between home and work where a community can gather."

Chefs Jon Nodler and Sam Kincaid found big-restaurant success in Philadelphia, but longed for something different. After closing their Philly restaurant, "they moved back west and settled in New Glarus, Wis., a village about 30 miles from Madison," Stein writes. "In October 2025, the couple opened Canter Inn in a restored Queen Anne-style building built in 1902." The inn offers neighborhood regulars and visitors a welcoming, elegant atmosphere with a full-service, first-come, first-served bar.

Chef Clare de Boer left a "coveted" chef career in New York to become the Stissing House tavern keeper. The Stissing House "leans into the building’s history as a tavern as far back as the 18th century," Stein reports. "De Boer focuses on the kind of fare a traveler craves when coming in from the cold: venison and Sherry pie, spit-roasted duck, cups of warming bone broth. De Boer also embraces a tavern’s essential function as a community hub."

Not sure how to become a regular at a tavern that's on the way home to work? Stein advises, "You just have to do what tavern-goers have done for the last 250 years: Show up and order a drink — then do it again and again until everyone there knows your name."

Waves of American doctors and nurses leave their practices and head to Canada to avoid U.S. political climate

Often born and trained in the U.S., many nurses and doctors are leaving the U.S. for Canada.
(Graphic by Oona Zenda, KFF Health News)

At a time when Americans can least afford to lose medical professionals, many are leaving the U.S., citing the country's current political climate as their reason for leaving. In rural parts of the U.S., already facing a chronic shortage of medical care providers, the loss of any medical professionals makes accessing care more difficult.

"American nurses, doctors, and other health care workers moving to Canada, and specifically British Columbia, where more than 1,000 U.S.-trained nurses have been approved to work since April 2025," Brett Kelman of KFF Health News reports. 

Justin and Amy Miller from Wisconsin serve as one example. They are both nurses who were born in the U.S. and trained at American schools, but didn't want to stay in the U.S. because of policies and cuts by the Trump administration, Kelman explains. They moved their family of five to Canada, where they found new nursing jobs.

As the Trump administration systematically slashed "funding for public health, insurance, and medical research, many nurses have felt the draw of Canada’s progressive politics, friendly reputation, and universal health care system," Kelman reports.

For U.S.-trained nurses, Canada is rolling out the welcome wagon. "Ontario and British Columbia have streamlined the licensing process for American nurses since Trump returned to the White House," Kelman writes. British Columbia also launched a $5 million advertising campaign last year to recruit nurses from California, Oregon, and Washington state."

Doctors are leaving as well. "Michael, an emergency room doctor who was born, raised, and trained in the United States, packed up his family and got out," Kelman reports. KFF did not use his last name because he expressed concerns about reprisals if he returned to the U.S. 

Rural Canadians, who also struggle with accessing medical care, are also hoping to attract some American medical professionals. Doctors Manitoba, which "represents physicians in the rural province that struggles with one of Canada’s worst doctor shortages, launched a recruiting campaign after the election to capitalize on Trump and the rise of far-right politics in the U.S," Kelman writes. 

Miseries and joys of mud season in rural parts of the U.S.

The brown slog and bog of a mud season driveway in
rural Wisconsin. (Photo by Donna Kallner, the Yonder)

As winter slowly gives way to spring, more northern rural parts of the U.S. enter into their own uniquely labeled time: Mud season. It requires tenacity, more than one pair of boots, and is -- just like you'd expect -- a dirty, slushy, sloppy, wet affair. Donna Kallner of The Daily Yonder writes, "Spring is still a ways off. Getting there is a slog."

Soldiering through days of muck and sludge "give us practice at being resilient," Kallner adds. "Mud season reminds us that we don’t persist just to collect a participation medal. We show up because that’s what rural people do." 

Kallner includes some tips about "showing up for our communities even when things get ugly" that are shared below.

January and February have passed, and mud season offers an opportunity to get together with friends and neighbors exiting hibernation. "So maybe we’ll plan to get the maple sapping crew together for a weenie roast in the woods," Kallner writes. "Bill makes a dandy homebrewed ale with Mike and Alice’s maple syrup. We should make some maple root beer soda, too. We all have sapping stories to tell. We’ll make it a party."

It's still cold outside, so taking time to enjoy indoor activities before gardening and fishing hobbies beakon can be good medicine. Kallner suggests, "It might be just more time spent watching basketball. March Madness gives us something to talk about besides politics and bear sightings."

Mud adventures and mishaps offer great distractions from the daily grind. "Stories about vehicles stuck in the mud are perfect (especially if someone else was driving). I like to open with the ruts the UPS driver left when he got stuck here," Kallner writes. "Then pass the baton. . . .If everyone is laughing, we all win."

It's time to think about the garden. "Northern gardeners in mud season are like baseball teams at spring training: Everything feels possible," Kallner adds. "We may not feel free to exchange some opinions with neighbors who vote for the other side. We will, however, share seedlings and fill cardboard boxes with clumps of lilacs and roses dug from our yards."

Mud season can be a time when shared experiences and even misery can help communities think about what brings them together. Kallner writes, "Just showing up for our rural communities won’t make our differences disappear. . . . But it’s a start."