Checkpoint: Democrats CAN reclaim Rural America
john warg
For America’s rural and small-town communities, years-long faith in Trump and the Republican Party is rewarded with lost income and immiserating living standards.
Yet, an opportunity lies outside major cities if only Democrats were to seek it out.
Farmers and rural folk in America are aching; Trump’s lurching trade wars have crashed crop prices, fuelling a torrent of bankruptcies and even suicide amongst farmers. Meanwhile, the already-crippling closure of rural hospitals accelerates with the President’s proposed hatchet blows to Medicare and Medicaid. Furthermore, the current Republican-controlled congress has not renewed 2018’s Farm Bill. This means back in September some programs already expired, and others will be dead by New Years Eve.
The largest part of these includes vital crop insurance, conservation funding, and food assistance, like SNAP. However, the Farm Bill also provides technical and financial support in matters of trade, agricultural research, biofuel production, rural education and animal welfare.
What’s worse is that, as the bill expires, mid-20th century legislation is reactivated, mostly laws which were pegged to the price and selection of crops set as early as 1910! Failing to renew the Farm Bill is a runaway freight train, and the Republicans are the railway engineer flicking through a magazine in his cabin.
Though it appears the GOP has finally wondered why the screech of wheels is getting closer, with yesterday’s announcement for a $12 billion bailout for farmers, which can only come into effect after the shutdown ends.
With or without this support, America’s rural population remains under more pressure than ever and as Trump’s disapproval breaks 54%, a crack may be opening for a political realignment.
To drive the wedge home though, Democrats can’t just offer to scrap the tariffs, renew the subsidies and expect votes to come flooding in for some poli-sci grad sent out to the country. Bold policy is needed not just because the issues are pressing but because the Democratic party’s political infrastructure and reputation have collapsed. One study found that in Texas alone Democrats no longer appoint party chairs or even run candidates in 20% of all rural counties in the state. This in turn depresses races and voter turnout at the state and national level. Without local alternatives for rural folks unhappy with Republicans, the Democrats may be missing a generation of organisers that could reinvigorate the party or force local GOP officials to listen to their constituents.
To win America’s agricultural heartland tangible rapid change in material conditions is needed, to show rural voters that Democrats care. The same social democratic ambition is required that saw farmers become an electoral pillar that sent FDR to the White House three times, and Truman twice. Roosevelt’s government saw similar rural poverty and rock-bottom crop prices and responded aggressively with the New Deal. He passed the Agricultural Adjustment Act, founded the Commodity Credit Corporation to protect farmers’ incomes, pushed for rural electrification and passed the Soil Conservation and Domestic Allotment Act to drive up prices while protecting soil health.
However, the cautious liberal-right that dominates the Democratic party leadership is neither politically bold nor keen to engage the heartland. With bread-and-butter issues like healthcare, social services and inequality, it’s the Social Democratic wing that is best positioned, rhetorically and ideologically, to lead rural voters back to the party. Bernie Sanders and Alexandria Ocasio-Cortez in their ‘Fighting Oligarchy Tour’ went to places like Viroqua, Wisconsin (pop. 4.700), Davenport, Iowa (pop. 100,000), and Wheeling, WV (pop. 26,000). They were met with large cheering crowds in places where it is hard to imagine Chuck Schumer getting so much as a golf clap.
Before sweeping FDR-style agricultural reform, struggling rural hospitals are a great first step for mobilisation.
Of those that remain open, nearly 50% of them were already in the red before the oncoming Trump cuts, and another 418 are ‘vulnerable to closure’. Rural hospitals have few insured patients, getting by via a patchwork of state funding, federal support, such as being designated ‘Critical Access Hospitals’ (CAHs), and some private insurance payments. However, the Trump administration is gutting healthcare spending, including CAH designations, and is replacing it with the ‘Rural Health Transformation Program’, providing barely one-third of lost funding.
The Glenn Medical Centre in the Sacramento Valley is typical of rural hospitals in both its population coverage of about 27,000, and its problems. While being in California, it is at the centre of a deeply agricultural community whose Republican House Rep, Doug LaMalfa, wants gay marriage banned, opposes abortion and supports Trump publicly.
Trump’s cut-induced closure leaves thousands with long backroad drives to access emergency and inpatient care.
However, situations like Glen County’s hospital aren’t unique and could be part of a popular and radical Social Democratic policy.
Nationalisation of rural hospitals.
Glenn Medical was run by a for-profit company, yet American Advanced Management (AAM) still required substantial federal and state funding to operate. It would be relatively simple for the federal government (with state help) to secure a hospital’s future as a "free at the point of care” facility. Glenn Medical’s removal from the insurance system would also cut out the need to pay private middlemen and reduce the expensive administrative bloat that private healthcare creates. The private model has failed rural America, with the 11% of rural hospitals that are private accounting for more than 36% of closures.
As Trump continues the Republicans’ wholesale neglect of rural America’s healthcare, fighting to reopen hospitals for the public is a hard campaign for conservatives to match. Social Democrats can realistically argue that it is cheaper and faster to reopen them via the public sector, as demonstrated by the spiralling costs of another rural-small town hospital reopened by AAM.
Madera Community Hospital, in Madera County, CA, shut down in 2023, limiting healthcare access for 160,000 people during two years of negotiations with creditors and bidders. It took a $57 million dollar state loan to AAM to renovate and reopen the hospital. With such lumbering private sector involvement, Social Democrats have plenty to work with, electorally speaking.
There are other issues specific to rural communities that can be targeted by Social Democrats. The National Conference of State Legislatures highlights the need for economic development, broadband and agriculture as other factors. Biden’s 2021 Infrastructure Bill provided $65 billion in funding for municipal internet but this has been killed in the state legislatures of 16 rural Republican-dominated states, thanks to lobbying by Telecom companies. For rural folks who might live hours from a major metropolis, the internet can provide access to education, information and work opportunities that could really help rural communities develop and slow economic flight to the cities.
Combining criticism of Trump’s tariff clown show, the looming threat of the expiring Farm Bill, and a plan to reopen hospitals and bring internet to rural communities, Social Democrats have a lot to offer Middle America.
