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How the Senate’s Version of the One Big Beautiful Bill Act Harms Rural America

For those of you hoping I’d write about how to grow grass, or when to move your livestock to the next pasture this week, try the links.

But I’m not writing about those things today because we have more urgent fish to fry: The Senate’s revised version of the One Big Beautiful Bill Act (OBBBA) continues to move through Congress, with key provisions that would be deeply harmful to rural communities. I covered some aspects of the bill last week, but here’s what’s happening now.

While advertised as a tax relief and economic development package, the Senate version retains and amplifies some of the most damaging aspects of the House bill. This article examines four major areas of concern: the devastating impact of Medicaid cuts, the inequities in tax policy that favor corporate agriculture over family farms, the economic fallout from reduced SNAP benefits, and the looming threats to rural education.

Medicaid Cuts Threaten Rural Health and Elder Care

The Senate version calls for even deeper cuts to Medicaid funding, including a cap on provider taxes, resulting in reduced federal contributions to states. Currently, states are allowed to tax Medicaid providers at 6% of net patient revenues. The Senate bill lowers the cap to 4%, phased in over a few years. That might sound small, but the impact is big. Many states rely on provider taxes to finance 20%–30% of their Medicaid budgets. Cutting this option forces them to either raise taxes elsewhere or cut services, eligibility, or provider reimbursement rates. States like Mississippi, West Virginia, New Mexico, and Kentucky—which rely heavily on provider taxes to fund Medicaid—could face budget crises.

The Senate’s changes are expected to slash rural hospital revenues by up to $70 billion over the next decade. Medicaid is a lifeline for rural communities, where nearly one in four residents depends on it for healthcare. It supports not only individual medical care, but also keeps rural clinics, hospitals, and home health services afloat.

The Senate has seemingly acknowledged the damage they will do and have tried to offset that with a $15 billion “Rural Hospital Stabilization Fund.” But health policy experts and rural hospital administrators widely agree this fund falls short. The projected $70 billion in losses mean the fund covers barely 20% of the need. Furthermore, the details of how this funding will be distributed remain unclear. If it is not equitably allocated or becomes entangled in bureaucracy, the fund may do little to prevent the closure of rural hospitals already operating on razor-thin margins.

In addition to hospital care, Medicaid also funds nursing home care for millions of older Americans. Nationally, about 60% of nursing home residents rely on Medicaid. With provider payment caps and stricter state eligibility rules, many nursing homes will be forced to reduce the number of residents they serve or close altogether. This could result in tens of thousands of vulnerable elders being forced out of care and into the homes of family members who are unprepared or unable to provide proper medical support.

SNAP Cuts Weaken Local Economies and Hurt the Most Vulnerable

SNAP (Supplemental Nutrition Assistance Program) is not only a vital food security tool but also a powerful economic stimulus in rural communities. Every $1 in SNAP benefits generates approximately $1.50 to $1.80 in local economic activity, primarily through spending at local grocery stores, farmers markets, and retail outlets.

The Senate version of the bill retains work requirements for SNAP recipients that disproportionately affect rural residents. Many rural areas lack reliable transportation, child care, and nearby employment opportunities. While the policy is framed as promoting workforce participation, the practical outcome is that people who are willing but unable to meet the new rules lose access to food. This includes older adults, people with undiagnosed disabilities, caregivers, and those in seasonal or unstable jobs.

As benefits are cut, grocery stores lose sales, local jobs are lost, and food insecurity increases. In counties where agriculture and food retail are major employers, this loss of SNAP spending hits both producers and consumers. The economic ripple effect erodes already struggling rural economies.

Want to know how many citizens in your state use Medicaid and/or SNAP?
Click to download this table.

Education Cuts Undermine the Future of Rural Communities

Though less publicized, the Senate bill also reduces federal support for rural education. Proposed changes include cuts to Title I funding, which supports schools with high percentages of low-income students, and potential rollbacks of funding for rural school transportation and broadband access programs.

More than 9 million students in the U.S. attend rural schools, many of which rely heavily on federal funding due to small local tax bases. In some states, over 60% of students attend rural or small-town schools. Losing federal education dollars means fewer teachers, reduced curriculum options, and deteriorating facilities. It also means less support for students who need it most—those in poverty, those with special needs, and those whose families are impacted by the other cuts in the bill.

Transportation is another critical issue. Rural school districts often cover large geographic areas and depend on federal subsidies to fund long, costly bus routes. Cutting this support increases district expenses and may force them to reduce services or cut days from the school calendar.

Permanent Tax Cuts for the Wealthy, Temporary Relief for Everyone Else

The Senate bill extends the corporate tax cuts and estate tax exemptions from the 2017 Trump tax law, making them permanent. These provisions overwhelmingly benefit the wealthy and large corporate interests, including agribusiness conglomerates. Meanwhile, the tax cuts for individual income brackets and the 20% deduction for pass-through income (Section 199A), which benefit many small farmers, are temporary and expire after 2026.

This disparity creates long-term advantages for big agriculture. Wealthy landowners and incorporated farms will continue to benefit from low tax rates and generous deductions, while family farmers face uncertainty and higher effective tax burdens after the cuts expire. Bonus depreciation and expensing rules further reward capital-intensive operations, encouraging consolidation and investment in large-scale machinery and infrastructure that smaller farms can’t afford.

The result is a policy landscape that favors expansion and corporate consolidation, putting more pressure on smaller farms to sell out or scale beyond their means. Over time, this accelerates the hollowing out of rural America and the decline of diversified, family-owned agriculture.

Conclusion

Despite claims that the Senate version of the One Big Beautiful Bill Act supports rural America, its provisions tell a different story. From healthcare to agriculture to education, rural communities are being asked to sacrifice their long-term well-being for short-term tax breaks that mostly benefit the wealthy and large corporations. Policymakers and citizens alike should take a hard look at what this bill truly delivers—and who will bear the cost if it becomes law.

Why do I Care?

Sixty percent of registered voters think this bill is harmful. So I’m not alone in my analysis. Many of those people may not be immediately affected by it, but like me, they know that we are all harmed when others suffer. We’re all impacted by an economy that shrinks because the population’s purchasing power is reduced. We’re all impacted by an increase in poverty, which can contribute to crime through various factors like lack of opportunity, social disorganization, and the need to meet basic needs. And as a country, we are negatively impacted by a move toward big agriculture over family farms and the communities they support.

Take action to change or stop this bill:

✅ Call your representatives today. You can find your Representative or Senator here, or by calling 202-224-3121
✅ Tell them: “Even if Medicaid and SNAP cuts are removed, this bill is still bad for rural America. I’m asking you to vote NO.”
✅ Share this with your neighbors, your co-op, your local paper, and on Facebook or church bulletin boards.

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Kathy Voth
Kathy Vothhttps://onpasture.com
I am the founder, editor and publisher of On Pasture, now retired. My career spanned 40 years of finding creative solutions to problems, and sharing ideas with people that encouraged them to work together and try new things. From figuring out how to teach livestock to eat weeds, to teaching range management to high schoolers, outdoor ed graduation camping trips with fifty 6th graders at a time, building firebreaks with a 130-goat herd, developing the signs and interpretation for the Storm King Fourteen Memorial trail, receiving the Conservation Service Award for my work building the 150-mile mountain bike trail from Grand Junction, Colorado to Moab, Utah...well, the list is long so I'll stop with, I've had a great time and I'm very grateful.

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