In this episode, "A Conversation About the State of America's Family Farms," Hannah Tremblay and Caitlin Arnold Stephano, both from Farm Aid, discuss issues impacting America's small and family farms.  

Hannah Tremblay is Policy and Advocacy Manager, where they manage Farm Aid's advocacy program and engage a broad coalition in support of policies that strengthen family farmers and family farm agriculture. Hannah has worked as an agricultural technical specialist and a farmer throughout the Northeast and Mid-Atlantic since 2014.   

Caitlin Arnold Stephano joined the organization in the fall of 2021 as the Hotline Program Manager. Caitlin grew up riding the tractor at her Grandfather's cherry and apple farm in Eastern Washington state, and has been working in agriculture, farmer organizing, and advocacy since 2006. Caitlin holds a Master's in Sustainable Food Systems with a focus on farmer mental health  

In this conversation, Michelle speaks with Hannah and Caitlin about Farm Aid's mission to support family farmers, the implications of the ongoing stalled farm bill, the myriad of challenges farmers face, including economic policies that harm small farms, and the importance of community advocacy and supporting local farmers by purchasing their goods. Also covered in this conversation is the increasing demand for the Farm Aid hotline services, the impact of climate change and immigration policy on farming, and the need for improved disaster relief and support systems for farmers.   

The conversation emphasizes the critical role of local and federal policies in sustaining small farms and the importance of community engagement in supporting farmers. 

In this episode, "Finding Common Ground in Community Engagement," Michelle welcomes Meredith Dean, the National Director of the Rural Urban Bridge Initiative's Community Works program, to discuss how rural communities are finding common ground and bringing people together, regardless of political differences, to address local needs.

Meredith brings 40 years of experience in community organizing, Democratic politics, non-profit management, and teaching in both formal and informal settings, from adults to higher education to kindergarten. She and her husband settled 39 years ago in a ruby red Virginia county nestled in the beautiful Blue Ridge section of the Appalachian Mountains, where they raised their son, 13 cats, four dogs, and a horse.

In this conversation, Michelle Rathman and Meredith Dean discuss the importance of community engagement in rural areas, particularly through the Community Works initiative. They explore the impact of national policies on local communities, the need for trust and collaboration across political divides, and practical steps for individuals to get involved in community improvement efforts. The discussion emphasizes the significance of addressing local needs, fostering relationships, and creating sustainable solutions for rural challenges.

The episode emphasizes how sustainable engagement requires ongoing effort and commitment, and how cross-political collaboration can lead to practical and effective solutions.

In this episode, "Ready. Set. No. The State of Medicaid Work Reporting Requirements Readiness," Michelle welcomes Research Professors Tricia Brooks and Leonardo Cuello, as well as State Health Policy Analyst Hannah Green, all joining us from Georgetown University McCourt School of Public Policy Center for Children and Families, to discuss their report published on September 4, 2025 titled "Are States Ready to Implement HR 1 and Medicaid Work Reporting Requirements?"  

In this conversation, Michelle, Hannah, Tricia, and Leo discuss the implications of the HR1 Medicaid work reporting requirements, focusing on state readiness, the impact on coverage for lawfully present immigrants, including the dispelling of misinformation on the matter, and the challenges that counties and rural communities, households, and economies can expect to face and manage in the months and years to come. 

The discussion highlights the importance of states meeting quality performance indicators, how funding and staffing cuts can further undermine the achievement of even minimum standards, and explores strategies for community engagement with multiple parties, as well as the urgency of advocacy around the rising uninsured rate among children and the financial strain on rural hospitals.  

The conversation closes with a discussion about data collection and transparency, noting that researchers rely on timely and accurate CMS data to inform and educate policy decisions. 

This episode was made possible by our partner, the National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno.  Starting October 20, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes on the evening of October 19, so don't wait! Visit narhc.org to register.

In this episode, "A Conversation About What Undermines Local Government and Public Service," Michelle welcomes Brooks Williams to discuss how anger and rage are impacting local governments. Brooks is a city manager whose two decades span public and private leadership. He is known for turning strategy into results, such as stronger finances, healthier cultures, and clear metrics that track real performance. He serves the QTF Regional Program, a performance-excellence initiative that helps organizations apply the Baldrige Excellence Framework, continuous improvement, and disciplined measurement to achieve lasting outcomes. A doctoral candidate in Public Administration, with an MPA from Liberty University, Brooks also writes to move leaders from noise to substance. His books, Performative Outrage: How Manufactured Fury Undermines Local Government and Public Service and Rising to Serve: Reimagining Public Administration for a New Era, challenge institutions to prove value through measurable excellence, accountability, and public trust.

Michelle invited Brooks to this episode to explore how anger and rage is impacting small governments. Together, they discuss the challenges and opportunities in public service, particularly in the context of performance outrage and the erosion of public trust. Brooks emphasizes the importance of transparency, civic engagement, and the role of social media in shaping public discourse. He advocates for a shift towards more constructive dialogue and the need for public servants to act as culture shapers within their communities. Brooks also highlights the necessity of civic literacy and education to empower citizens and improve local governance.

This episode was made possible by our partner, The National Association of Rural Health Clinics, and they invite you to rendezvous with them in Reno!!!

Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this episode, "HRSA's Dwindling Rural Health Commitments," we kick off with a conversation between Michelle and Alexa McKinley Abel, Director of Government Affairs at the National Rural Health Association. They delve into recent developments from the House Appropriations Committee related to the FY2026 Labor-HHS appropriations bill, which proposes significant investments and increases in rural health funding. The two also dissect a new provision in the Rural Hospital Provider Assistance Program, which, if passed, offers financial support to at-risk hospitals. They wrap up with a discussion that underscores the need for increased funding and the impact of community stories in underlining the importance of these programs.

Next, Michelle welcomes Carole Johnson, former Administrator of the Health Resources and Services Administration, and current Senior Fellow at the Century Foundation. Michelle speaks with Carole about the current state of rural health, focusing on the challenges posed by workforce reductions, funding cuts, and the need for community engagement. They discuss the impact of these issues on healthcare services in rural areas and the importance of advocacy in securing the necessary resources in the long term. Carole emphasizes the need for immediate action to address funding gaps and significant cuts to HRSA's workforce, responsible for administering rural health programs, some of which have been eliminated or paused.

In the second half of this in-depth episode, Michelle speaks with Toniann Richard, CEO of HCC Network, about the critical issues facing rural health organizations, particularly in relation to Medicaid and the Rural Health Transformation Fund. They discuss the challenges of navigating policy changes, the importance of grassroots advocacy at the state level, and the need for community engagement in health initiatives. The conversation also addresses vaccine hesitancy in rural Missouri and the role of public health in these areas in building confidence and capacity, highlighting the importance of providing reliable information and support to communities.

This episode was made possible by our partner, The National Association of Rural Health Clinics and they invite you to rendezvous with them in Reno!!!

Starting October 20th, the two-and-a-half-day NARHC Fall Institute offers a unique in-person agenda, along with three pre-conference webinars the week before. It's a rare opportunity to deeply engage with the pressing issues facing Rural Health Clinics today. Plus, with unmatched networking and a throwback 90s Bash, you'll leave energized and reconnected. Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this episode, Education, Workforce & Tariffs: Rough Roads for Rural Ahead, the episode begins with Alexa McKinley Abel, Director of Government Affairs at the National Rural Health Association, who provides a rundown of the Senate Appropriations Committee's markup of the 2026 Labor Health and Human Services, Education, and Related Agencies Bill. Alexa detailed what the markup means for rural health; many of the programs that were initially proposed for elimination in the President's budget are actually funded and funded at higher levels than in past years. She continued the conversation by providing some key highlights of the bill and concluded by noting that the House and Senate must agree on numbers and pass the same budget. It remains to be seen where the house will stand in the FY26 funding bill.

Next, Michelle welcomes Dr. Jeff Strohl, Research Professor and Director of the Georgetown University Center on Education and Workforce (CEW). They discuss the challenges facing rural education and workforce development, particularly in light of recent policy changes and economic shifts. They examine the impact of AI on job markets, the significance of community colleges, and the challenges that rural students face in accessing education and training. The discussion highlights the importance of aligning educational programs with labor market demands, as well as the need for increased investment in career navigation and employer engagement to support rural communities.

In the second half of this in-depth episode, Gbenga Ajilore, Chief Economist at the Center on Budget and Policy Priorities, joins us to explore the significant impacts of recent policy changes on rural households and communities, focusing on education funding, Medicaid and SNAP cuts, tariffs, and tax cuts. Gbenga shares how these factors contribute to economic challenges in rural areas, emphasizing the need for advocacy and storytelling to highlight the real-life effects of these policies.

SHOW RESOURCES

https://cew.georgetown.edu/cew-reports/bridging-middle-skills-gap/

https://www.cbpp.org/research/economy/the-republican-agendas-triple-threat-to-black-households-economic-well-being

This episode was made possible by our partner The National Association of Rural Health Clinics.

The National Association of Rural Health Clinic invites you to rendezvous in Reno!!!

Beginning October 20th, the two and a half day NARHC Fall Institute features a powerful in-person agenda plus three pre-conference webinars the week before, it’s your chance to engage deeply with the pressing issues facing Rural Health Clinics today. With unmatched networking, and a throwback 90s Bash, you’ll leave energized and reconnected.

Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this Rural Impact Extra Episode: A Conversation about Rural Prosperity and its Connection to Policies, Past, Present & Future, Michelle leads the episode with a discussion with two esteemed experts in the field. Tony Pipa, a Senior Fellow in the Center for Sustainable Development at the Brookings Institution, and Brent Orrell, a Senior Fellow at the American Enterprise Institute(AEI), bring their wealth of knowledge and experience to the conversation.

Tony, Brent, and Michelle discuss the Brookings-AEI Commission on US Rural Prosperity, a significant bipartisan endeavor. This commission has a shared mission to enable rural prosperity in the 21st century by strengthening economic opportunity, resilience, and quality of life across rural America. Drawing on rigorous analysis and informed by a series of research symposia led by Brent and Tony, America’s Rural Future will share regular insights through policy briefs, public events, and narrative storytelling, informed by site visits and conversations with rural leaders across the country.

The discussion explores the challenges and opportunities facing rural America, including economic transformation, workforce development in the age of AI, the importance of infrastructure, climate change resilience, health outcomes, and the need for effective governance and policy coordination. Together, they emphasize the crucial role of civic engagement and community involvement. This is not just a conversation, but a call to action for all those who care about the future of rural policy.

In part two of this episode, Michelle is joined by Matt Hildreth, who serves as the Executive Director of RuralOrganizing and RuralProgress, a nationwide network of nearly one million advocates and civic leaders in small towns and rural communities that have successfully pushed for over $1 billion in new economic prosperity programs for economically disadvantaged communities.

Matt and Michelle delve into the importance of empowering rural leaders, the impact of Medicaid on small communities, and the innovative 2050 Festival. This festival, aimed at engaging the next generation of civic leaders, is a beacon of hope for the future of rural America, inspiring optimism and confidence in the potential of our rural communities.

This episode is brought to you by The National Association of Rural Health Clinics. NARHC invites you to rendezvous in Reno!!! 

Beginning October 20th, the two and a half day NARHC Fall Institute features a powerful in-person agenda plus three pre-conference webinars the week before. It’s your chance to engage deeply with the pressing issues facing Rural Health Clinics today. 

With unmatched networking and a throwback 90s Bash, you’ll leave energized and reconnected. 

Registration closes the evening of October 19th, so don't wait! Head to narhc.org to register.

In this extra episode of the Rural Impact Michelle welcomes Cynthia Wallace, Executive Director of the non-profit, New Rural Project, which she co-founded in April 2021 to discuss the impacts of H.R.1, as well as the how Cynthia and The New Rural Project are amplifying the voices of rural young people and marginalized residents in North Carolina so that they are heard and seen, and they get electorally and civically engaged.

Before starting her non-profit, Cynthia spent over 25 years in financial services, retiring from Synchrony (formerly GE Capital) after 20 years spent there. She was the 2020 Democratic Nominee for North Carolina’s 9th Congressional District. Prior to running for public office, she was the Chair of the 9th Congressional District of the North Carolina Democratic Party. Cynthia was appointed in early 2021 to the NC State Banking Commission by Governor Cooper and serves on the boards of Democracy NC and the Levine Museum of the New South. 

Michelle and Cynthia discuss the challenges facing rural communities, particularly in light of recent legislative changes. She shares her background and the motivation behind founding New Rural Project, which aims to engage rural voters, especially those marginalized in the civic process. The discussion highlights innovative strategies for community engagement, including deep canvassing, barbershop conversations, and empowering young voices in politics. Cynthia emphasizes the importance of listening to community needs and the impact of grassroots activism on local policy. The conversation concludes with a call to action for listeners to support rural advocacy efforts, become and stay engaged in local politics, and a warning about a rapid increase in voter suppression laws enacted across the U.S. in 2025. Show

Resources:

https://www.newruralproject.org/

https://votingrightslab.org/report/2025-legislative-sessions-to-date-key-election-policy-trends/

Michelle kicks off this episode with Edwin Park, Research Professor at the Georgetown University Center for Children and Families, within the McCourt School of Public Policy. His work primarily focuses on Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act. Previously, he worked for 17 years at the Center on Budget and Policy Priorities, most recently as Vice President for Health Policy. He was also a health policy advisor for the White House National Economic Council, a Medicaid professional staff member for the U.S. Senate Finance Committee, and a health law attorney in private practice. In addition, Edwin served on the Biden-Harris Presidential Transition team. He is also a member of the National Academy of Social Insurance.

During this conversation, Michelle and Edwin discuss the implications of H.R.1, also known as the One Big Beautiful Bill Act, focusing on the significant cuts to Medicaid and their impact on rural health systems. They examine the financial strain on rural hospitals, the challenges faced by states implementing Medicaid expansion, and the broader implications for communities across the political spectrum. The discussion highlights the importance of advocacy and accountability in response to these changes.

In part two of this episode, Michelle meets with Shawn Martin, Executive Vice President and Chief Executive Officer of the American Academy of Family Physicians (AAFP), and Nathan Baugh, Executive Director of the National Association of Rural Health Clinics (NARHC). Shawn provides strategic leadership to the AAFP and directs the mission-driven work of the nation’s largest primary care organization. A strategic leader with a proven track record of accomplishments, Shawn is nationally recognized for his thoughtful leadership on a range of health care policy and workforce issues. While his career portfolio includes focused work on numerous healthcare and public policy issues, he is best known for his extensive work and national leadership on the development and implementation of primary care delivery and payment models, as well as workforce issues.

Before becoming the Executive Director of NARHC in July 2022, Nathan served as the Director of Government Affairs. In this role, he was instrumental in the passage of the Rural Health Clinic Medicare payment reforms, which were signed into law as part of the Consolidated Appropriations Act of 2021. This legislation was the most significant overhaul to the rural health clinic program in the last twenty-five years. As Executive Director, Nathan provides strategic direction for NARHC and remains involved in RHC advocacy priorities, including telehealth and Medicare Advantage.

With all eyes focused on legislation that will have sweeping implications for rural health clinics and physicians, Shawn, Nathan, and Michelle discuss the impact of stagnant payment rates and administrative burdens, differences between rural health clinics and FQHCs, the effects of Medicaid cuts, barriers to healthcare, challenges in recruiting and retaining healthcare professionals in rural areas, the importance of advocacy at the state level to mitigate the negative impacts of recent legislation, and strategies for healthcare professionals to engage in policy discussions and advocate for change.

In this extra episode of Rural Impact, Michelle Rathman begins the episode with Anthony Flaccavento. Anthony is a farmer and rural development consultant from Abingdon, Virginia, in the heart of the Appalachian Coalfields. The Founder of Appalachian Sustainable Development, he has focused most of his work over the past four decades on building healthier food systems and more diverse, locally rooted economies in Appalachia and around the world.

The Democratic Candidate for Congress in Virginia’s 9th District in 2018, Anthony, co-founded the Rural-Urban Bridge Initiative, or RUBI, in 2021. A national organization, RUBI works to help progressives, liberals, and Democrats understand the underlying causes of the rural-urban divide and take concrete steps to win back rural and working-class people through education, media work, policy change, and local community action.

Michelle and Anthony discuss several pressing issues facing rural communities in America, including the importance of understanding the rural-urban divide, building trust, and developing effective communication strategies to engage rural voters. Anthony outlines seven key steps for the Democratic Party to reconnect with rural America, emphasizing the need for local investment and acknowledgment of past policy mistakes. The conversation highlights the significance of grassroots efforts and the Rural New Deal as a framework for revitalizing rural communities.

Michelle closes out the episode by sharing with listeners some of the impacts of the One Big Beautiful Bill that passed the Senate on July 1, 2025, highlighting the critical effect of proposed Medicaid cuts on rural hospitals and communities. She cites alarming statistics regarding funding reductions, potential hospital closures, and the broader implications for healthcare, education, and economic stability in rural areas. Michelle emphasizes the urgent need for advocacy and awareness among policymakers to protect rural America from detrimental legislative changes.