MEMORANDUM
TO: Interested Parties
FROM: Jaime Harrison, DNC Chair
DATE: January 31, 2025
RE: Donald Trump’s New Administration Aims to Devastate Rural America

In his first week and a half as president, Donald Trump made abundantly clear that he lied to the American people. After spending his entire campaign denying his connection to Project 2025 while promising to bring down prices on Day One, President Trump dropped the charade and swiftly worked to make his “severely unpopular” Project 2025 agenda a reality. Trump elevated architects of Project 2025 to lead his administration and enacted Project 2025 policies in an avalanche of executive orders: attacking essential programs, rescinding Biden-era cost-saving measures and laying the groundwork for another tax handout to billionaires. Now, as Donald Trump uses the might of the federal government as a tool to enrich the ultra-wealthy, the American people bear the costs.

In fact, President Trump’s Project 2025 agenda takes specific aim at many of the voters who sent him to the White House, particularly those living in rural communities where he expanded support last November. An examination of Trump’s second term agenda and first administrative actions reveals that rural families and the resources they rely on are in greater jeopardy than ever before. Bottom line: Donald Trump lied to rural Americans on the campaign trail, and is thanking rural voters by making their lives harder and more expensive. 

Health Care

Health care is critical to ensuring rural Americans are able to maintain their quality of life and not have to travel hundreds of miles for a medical emergency or to take an aging parent or child to an appointment. Trump’s Project 2025 agenda will have severe consequences for rural health care. Donald Trump and JD Vance have repeatedly affirmed their desire to terminate the Affordable Care Act. In a December post-election interview, Trump once again insisted he would attempt to repeal the ACA, despite only having “concepts of a plan” to replace it. Trump’s successful termination of the ACA would spike the costs of health care for everyday Americans, eliminate protections for preexisting conditions, and deny young people the ability to remain on their parents’ insurance plans. 

Everyone deserves access to affordable health care – but the stakes are even higher for individuals living in rural communities. People living in rural communities face greater obstacles to connectivity and must often travel long distances – sometimes requiring time off work or child care support – just to access basic care. Rural Americans are less likely to have private or employer-sponsored health insurance. Medicaid coverage through the ACA is often the only way rural families can afford medical treatment – including medical care for children.

A new study out this month from the McCourt School of Public Policy at Georgetown University found that for the vast majority of states, children in small towns and rural areas depend more on Medicaid than their urban counterparts. The study revealed that in six states, nearly all of which went to Trump in the November election, at least half of all rural children relied on Medicaid coverage.

On his first day in office, Donald Trump rescinded an executive order issued by President Joe Biden to strengthen protections for Medicaid. Trump and his congressional allies’ attacks on Medicaid are just getting started. In his first term, Donald Trump repeatedly sought to slash hundreds of billions of dollars in Medicaid funding. Now, for his first legislative priority, Trump intends to extend his “extremely unpopular” 2017 tax handout – pushing for a massive reconciliation bill that would gift billionaires with tax breaks by making deep cuts to life-saving programs like Medicaid. This means less money in the pockets of rural Americans and greater uncertainty that they will be able to receive the care they need.

In 2023, 18.6 million Americans received coverage thanks to the ACA’s Medicaid expansion. States that have expanded Medicaid cut their rural uninsured rates to half the level of nonexpansion states. Trump’s Project 2025 agenda would strip families of their Medicaid benefits and push affordable health care out of reach. More than 3 million adults in nine states would be at immediate risk of losing their health coverage if Trump and Republicans reduce the federal Medicaid funding that enables states to expand eligibility. 

Rural hospitals also rely on Medicaid and Medicare funding to keep their doors open. In the midst of a rural hospital shortage, under Project 2025, hospitals could be at risk of closure due to cuts to these programs, in addition to those that have already closed due to Republicans in states like Texas refusing to expand Medicaid. In these states where Republicans have blocked Medicaid expansion, rural hospitals have already closed, severely limited emergency care access, or slashed specialist care — like obstetrics and gynecology — due to lack of funding. And this isn’t just about access to care, rural hospitals are often the lifeblood of rural communities serving as a large employer and economic driver of rural areas. Threats to their funding means threats to these communities and what makes them so special. 

Reproductive Health

A majority of the more than 2.5 million women of reproductive age without easy access to obstetric providers live in rural communities. A recent study found most rural hospitals have closed their maternity wards, placing rural women at greater risk of experiencing dangerous and even deadly maternal and prenatal outcomes. 

Donald Trump’s overturn of Roe v. Wade has further compounded a reproductive health care crisis for rural women. Thanks to Trump, women in 19 states – many with large swaths of rural land – now live under an extreme abortion ban. Some women must travel over 700 miles to access abortion care. Data shows abortion bans increase the likelihood of harmful health outcomes for both women seeking abortions and all pregnant women, especially those experiencing pregnancy complications. Since Trump’s overturn of Roe, health experts have frantically raised the alarm as infant and maternal mortality rates spike in states with Trump-enabled abortion bans.

Despite insisting he’d leave reproductive health care policy to the states, during his first week in office, Trump already signed executive orders gutting access to reproductive health care. Because of Trump, women are already needlessly dying from draconian abortion bans. In his second term, Trump has immediately proven he will make this crisis worse by further restricting abortion care. 

Trump’s current nominee to lead the Department of Health and Human Services, Robert F. Kennedy Jr., confirmed he intends to do Trump’s bidding and carry out Project 2025’s anti-choice agenda – including restricting access to medication abortion, which make up more than half of all U.S. abortions.

Opioid Treatment

In 2024, the U.S. Centers for Disease Control and Prevention warned that the rates of drug overdose deaths in rural areas had surpassed rates in urban areas. The remote geography of many rural communities creates obstacles to accessing treatment and recovery programs, presenting unique challenges to addressing the opioid epidemic in rural America. 

In response to this crisis, the Biden-Harris administration made unprecedented investments into public health, achieving the first decline in the overdose death rate in more than five years. Donald Trump and his nominee to lead the Department of Health and Human Services seek to undo this progress and abandon the fight against opioid addiction in rural communities. 

RFK Jr. embraces fringe conspiracies at odds with science and proven public health standards. He has threatened to fire science staff at the Food and Drug Administration and National Institutes of Health if given the opportunity. Recent polling finds a majority of Americans distrust RFK Jr. when it comes to health. Yet Trump made RFK Jr. his top pick to lead a department with a $1.8 trillion annual budget to oversee health-related public programs, including addiction treatment and prevention.

As president, Donald Trump repeatedly proposed budgets that would have slashed funding for substance abuse programs, including gutting the Office of National Drug Control Policy by 95%. Meanwhile, RFK Jr. conceives of addiction at least in part as a spiritual issue and touts “tough love” and so-called “healing farms” – where those suffering from addiction can “reconnect to America’s soil” – as viable recovery options. In fact, the U.S. government previously pursued a program akin to RFK Jr.’s healing farms. The efforts were shut down amid abuse allegations and never achieved evidence of successful long-term recovery for residents. 

Rural Farmers

The Biden-Harris administration made historic investments in rural infrastructure, conservation programs, and local food systems. Donald Trump’s Project 2025 agenda seeks to erase this progress by slashing the safety nets farmers depend on. Project 2025 calls for the repeal of major federal farm aid programs like crop insurance and the elimination of subsidies that provide billions in support to America’s farmers.

From extreme weather events to dramatic fluctuations in production costs like fertilizer, fuel, and labor, agriculture is an innately volatile industry. Crop insurance programs protect farmers from substantial drops in crop prices or lost revenues due to unforeseen circumstances. Small family farms depend on these types of programs to manage risks. Now, Donald Trump threatens to make farming even riskier. Without it, family farms are often one unexpected weather event away from ruin. Experts warn that, entering 2025, the uncertainty farmers’ face will only increase due to Trump’s Project 2025 agenda.

Trump’s attacks on farmers is nothing new. As president, Trump proposed massive cuts to the United States Department of Agriculture every year he was in office, including cuts to subsidy and crop insurance programs. For decades, family farms have struggled as Republicans embraced a “get big or get out” mentality that spurred the corporate consolidation of agriculture and squeezed small farms out of the industry. Trump’s Project 2025 would place even greater burdens on small and medium-sized family farms and eliminate the safety nets these farmers rely on. Even when the Trump administration did successfully deliver aid to the agriculture industry, independent watchdogs confirm a majority of the support benefited large farm conglomerates, rather than family farmers.

Rural families are further threatened by Donald Trump’s Project 2025 plans to cut additional forms of federal aid such as natural disaster relief. Trump’s Project 2025 agenda would end the Small Business Administration’s direct lending program and rip away access to federal recovery grants. During his first week in office, touring sites still reeling from natural disasters, Donald Trump threatened to  get “rid of FEMA,” the federal agency responsible for coordinating with state and local governments on natural disasters. The idea is pulled directly from Project 2025, which demands an overhaul of the Federal Emergency Management Agency (FEMA) — leaving state and local governments to manage natural disasters on their own.

Costs and Taxes

Economists have sounded the alarm that Donald Trump’s Project 2025 agenda could set off an inflation bomb and jack up prices for American consumers. New polling shows that Americans oppose Donald Trump’s proposed tariffs, agreeing that they would raise prices on basic items. Still, Trump and his out-of-touch, unpopular billionaire Cabinet are eager to subject hardworking families to their “$100 billion national tax” that would drastically raise prices on everyday necessities like energy, cars, and groceries – while destabilizing the agriculture industry. In fact, Trump has threatened to enact these tariffs as early as next week. 

Farmers do not have to use their imagination to anticipate the damage Trump’s tariffs would inflict. In Trump’s first term, following his reckless approach to trade and tariffs, farm bankruptcies soared. The Chief Economist at the Farm Bureau described farmers’ deteriorating financial conditions as a “direct result” of Trump’s first-term tariffs. Experts also blame Trump’s tariffs for shrinking the global demand for U.S. produce, as foreign consumers abandoned U.S. farmers and turned to alternative markets around the world to purchase products that weren’t American-made. 

A 2022 study from the United States Department of Agriculture estimated that Trump’s first-term tariffs cost U.S. farmers $27 billion in agricultural exports. The consequences of Trump’s previous tariffs still impact today’s farming industry. If Trump implements an even more aggressive round of tariffs, as he promised during his inauguration, the agricultural industry will be decimated, while farmers – along with the rest of America – grapple with the soaring prices of consumer goods at home. 

School Funding 

More than 27,000 public schools serve rural areas across the United States, offering an array of classes, youth sports, and arts to some 10 million children. Trump’s Project 2025 agenda threatens these hubs of rural life. Doubling down on his attacks on public education during his first term, Trump has vowed to significantly cut federal education funding and eliminate the Department of Education.

Trump and his billionaire Department of Education secretary pick Linda McMahon – along with many Republican billionaire funders – have long supported pulling tax dollars away from public schools that need them. And it’s not what rural communities want – rural voters have repeatedly rejected voucher programs. In 2024, voters across Colorado, Kentucky, and Nebraska voted down voucher initiatives. Even rural Republicans have vocally denounced taking resources away from rural schools into city schools, recognizing the critical resource rural schools offer to families living in remote areas. Still, Trump is pushing policies that would take money away from our public education system and put them into schools that simply aren’t in rural America. Public schools are often the only educational option for children living in rural areas. What’s more, rural public schools serve as an economic engine for the greater community. Trump doesn’t just promise to decimate rural economies in the present – he fundamentally threatens rural growth in the future with his Project 2025 plan for private school vouchers.

The United States Postal Service

One of Donald Trump’s most unpopular Project 2025 proposals would disproportionately harm rural Americans: Trump and his billionaire advisor Elon Musk are looking to sell off the United States Postal Service. 

The Postal Service is “foundational” to our economy and health care. After the National Parks Service, the Postal Service is the second most popular government entity; beloved for the vital public services it provides. Trump’s proposed cuts to the Postal Service could leave countless Americans stranded without access to vital resources – especially Americans living in rural communities.

Unlike other private delivery services, the Postal Service is obligated by law to serve all postal addresses, without differing fees. If the Postal Service was privatized, some 70 million Americans – a vast majority of whom live in rural areas – could face higher costs or lose delivery services altogether. Seniors and disabled Americans in rural areas especially rely on the Postal Service to access vital medications. Due to existing strains on rural health care infrastructure, they would be left with few alternatives to access medicine if Trump privatizes the Postal Service.

Trump has a long record of attacking the Postal Service and the vital work it provides, repeatedly trying to gut services and raise costs for Americans during his first term. In 2025, he’s dead set on finishing the job. 

Bottom Line

In his first term, Donald Trump relentlessly pursued policies that harmed rural communities, threatened their way of life and targeted federal programs that empower rural Americans. Now, after historic investments in rural America under the Biden-Harris administration, Trump’s first week in office leaves no room for doubt: Trump will enact his Project 2025 agenda and devastate rural communities across America. 

In red states and blue states alike, rural Americans deserve representatives who will invest in their communities. In 2025 and beyond, Democrats will fight tooth and nail against Trump’s Project 2025 agenda to protect the programs rural families rely on.