Presidential candidates layout plans for Rural Life and Health in Farm Bureau survey


President Trump and his Democratic challenger, former Vice President Joe Biden, each took time to respond to the American Farm Bureau Federation’s survey on agriculture issues.

Question from the American Farm Bureau Federation: Rural communities play an important role in our nation’s economy. At the time of the 2010 Decennial Census, almost 60 million people, about 19% of the population, lived in rural areas of the United States, home to a majority of U.S. manufacturing, farming and ranching. Greater access to broadband and healthcare in rural areas, enhanced infrastructure investment, reducing opioid addiction, addressing mental health challenges and helping rural economies via rural entrepreneurship and Main Street-friendly tax policies are important components to revitalize rural America. As president, how would you ensure that rural Americans have economic opportunity, greater access to broadband and healthcare, and well-maintained infrastructure to move food, fiber and fuel to consumers and ports, which are all necessary for a sustainable future?

Biden: Rural America is home to roughly 20% of Americans, but we are all connected to rural communities in many ways. Rural Americans fuel us and feed us. Rural lands provide us with places to spend time outdoors with friends and family and relax.

A healthy, vibrant rural America is essential to the success of our country. Yet in small town after small town, parents watch their kids and grandkids leave rural communities because there just is not enough opportunity for them at home. For too many rural Americans, a pathway to the middle class is out of reach if they stay in their rural communities.

The moral obligation of our time is rebuilding the middle class, so that this time everyone comes along regardless of their race, gender, sexual orientation, disability or zip code. It should not be dependent on whether they live in a city center, a small town, or a remote area. Everyone means everyone.

We will build a pathway to the middle class for rural Americans, in rural America. We will pursue a rural economic development strategy that partners with rural communities to invest in their unique assets, with the goal of giving young people more options to live, work, and raise the next generation in rural America. It’s not just good for those in rural America, it’s good for everyone across our country. Our full plan for rural America can be viewed at but below are some of our top priorities:

Broadband: High-speed broadband is essential in the 21st Century economy. Yet far too many rural communities still don’t have access to it. Rural Americans are over 10 times more likely than urban residents to lack quality broadband access. At a time when so many jobs and businesses could be located anywhere, high-speed internet access should be a great economic equalizer for rural America, not another economic disadvantage. Investing $20 billion in rural broadband infrastructure has the potential to create more than a quarter million new jobs. The Biden-Harris Plan will triple Community Connect broadband grants and partner with municipal utilities to bring cutting-edge broadband connections to communities across rural America.

Health care: Rural America faces unique challenges and opportunities when it comes to access to quality health care. In many rural communities, the local hospital is one of the largest – if not the largest – employers. Keeping our rural hospitals open is critical not only for saving lives, but also for supporting local economies in rural America. Yet, since 2010, more than 100 rural hospitals across the United States have closed. Combined, these closures represent the loss of over 10,000 jobs. And, they could mean life or death for patients in rural communities. Already, someone injured in a rural area has to travel, on average, nearly twice as far to get to the closest hospital as someone injured in an urban area. These critical moments lost in travel time are one reason an estimated 60% of all trauma fatalities occur in rural communities.

You can read our full health care plan here. To specifically help rural Americans, our plan will also:

Keep our rural hospitals open by:
Defending the Affordable Care Act. The first step to save our rural hospitals is to defend the Affordable Care Act. In fact, one proposal to repeal the Affordable Care Act would have caused $1.7 billion in cuts to rural hospitals, 181 additional rural hospitals “forced into the red,” and nearly 38,000 lost jobs. Our Administration is not going to eliminate the Affordable Care Act, we’re going to build on it.
Finishing the job of expanding coverage to low-income adults. Research found that, in states that took up the Affordable Care Act’s Medicaid expansion, the expansion was a critical tool in keeping rural hospitals open. Yet, 14 states have still not expanded Medicaid eligibility, and an estimated 4.9 million individuals would be eligible for coverage but for their state’s inaction. My plan will enroll all of these individuals in a new public option, without a premium and with benefits like those offered in Medicaid. This isn’t just the right thing to do, it will help rural hospitals remain solvent. And, under the Biden-Harris Plan, which preserves individuals’ ability to choose private insurance, these hospitals won’t be threatened by having to get by on low Medicare reimbursement rates for all.
Giving rural hospitals the flexibility they need to keep their doors open and care for their patients. The Biden-Harris Administration will provide rural health care providers with funding and flexibility necessary to identify, test, and deploy innovative approaches to keeping their doors open and providing care for the unique needs of rural The Affordable Care Act supports this type of innovation, for example through demonstration projects like the Pennsylvania Rural Health Model, which is giving rural hospitals in the state more flexibility to decide how best to spend dollars to improve the health of the population they serve. The Biden-Harris Plan will expand funding for these types of demonstration projects, and then accelerate efforts to replicate proven models to other rural hospitals across the country. And, the Biden-Harris Plan will identify and eliminate federal rules making it harder for rural hospitals to serve their communities. For example, many rural hospitals serving small populations do not have enough patients to maintain inpatient care, but those communities still need a 24/7 emergency department. One approach to ensure they can keep their doors open is to create a new designation, the Community Outpatient Hospital, as proposed in the bipartisan Save Rural Hospitals Act. The Biden-Harris Administration will make sure the federal government is helping rural hospitals meet community needs, not serving as a roadblock.
Adequately funding our rural hospitals. To help hospitals keep their doors open, we support the elimination of payment cuts and additional payments for rural hospitals as detailed in the bipartisan Save Rural Hospitals Act.
Expand primary care and innovative health care delivery models in rural communities by:
Doubling funding for community health centers. Community health centers provide primary, prenatal, and other important care to underserved populations. The Biden-Harris Plan will double the federal investment in these centers, expanding access to high quality health care for the populations that need it most. More than half of community health centers are in rural areas.
Equipping rural community health centers to be hubs for healthy communities. We will establish a grant program to help community health centers hire social workers or other professionals to coordinate resources necessary for community health, such as transportation to get patients to health centers and connections to housing and nutrition services.
Expanding the pipeline of rural health care providers. The Biden-Harris Administration will use a comprehensive approach to increase the number of rural individuals going to medical school or other training programs and returning or staying in rural communities to provide care, with a focus on primary care physicians, nurses, nurse practitioners, nurse anesthetists, and other in-demand providers. This initiative will include additional funding for residency programs in rural areas, expanding the National Health Service Corps, and developing high school-community-college-health-center partnerships to inspire rural youth to pursue jobs in health care and pursue the advanced credits or industry credentials that will put them on the path to success in the field.
Infrastructure: We will make smart infrastructure investments to rebuild the nation and to ensure that our buildings, water, transportation, and energy infrastructure can meet America’s economic needs and withstand the impacts of climate change. My administration will use this infrastructure funding to ensure that rural communities across the country have access to clean, safe drinking water. We will modernize the lock and dam system vital to getting rural products to markets, leveraging the federal resources to the maximum extent possible with the private sector. And, we will build the roads to give farms and small town businesses access to markets and an efficient means to participate in the world economy.

Opioid Crisis and Substance Use Disorder Treatment: You can read our full plan to end the opioid crisis HERE. As it relates to rural communities, we will pursue comprehensive strategies to expand access to treatment, particularly in rural and urban communities with high rates of substance use disorders and a lack of access to substance use disorder treatment services. My administration will invest $75 billion in flexible grants to states and localities for prevention, treatment, and recovery efforts. State and local agencies will also be able to use funds to enhance data systems allowing them to better target resources to individuals and communities most in need of support. As a condition for receiving funding, grant recipients will have to provide long-term, comprehensive strategic plans that address the multifaceted nature of the substance use disorder crisis. Funds may be used to:

Invest in evidence-based, cost-effective prevention programs in schools and communities to reduce the development of substance use disorders.
Mitigate harms from opioid and other drug use, including overdoses. Local communities will be able to use the funds to implement evidence-based programs designed to stop the spread of diseases like hepatitis C and HIV, including syringe service programs, or to scale up innovative programs like the safe station initiative started in Manchester, New Hampshire, which allows those seeking help to go to fire stations in order to be connected to treatment and recovery services.
Expand access to ongoing treatment and recovery services. Communities will be able to use funds to increase access to substance use disorder and mental health treatment and other services to support long-term recovery, including peer support networks and recovery coaches, and better integrate primary care and behavioral health. Recognizing the strong evidence that social supports, including family support, may have a positive impact on the treatment of HIV, we will support the development of family-centered models for substance use disorder treatment and recovery.
Mental health: We will build new health clinics and deploy telehealth in rural America. The Obama-Biden Administration successfully used the USDA Community Facility Direct Loan Grant Program to build rural hospitals and mental health clinics across rural America and equip them with the best technology. A Biden-Harris Administration will expand this grant funding, with a focus on accelerating the deployment of telehealth for mental health and specialty care. Telehealth – the use of videoconferencing and other technology to provide remote care – can be a vital resource for rural communities with limited access to providers.

Economic development: Entrepreneurs in small towns and rural areas should have access to the capital they need to realize their dreams. A Biden-Harris Administration will dramatically expand funding for Community Development Financial Institutions (CDFIs) and the Rural Microentrepreneur Assistance Program to help rural entrepreneurs. We will expand the number of Rural Business Investment Companies to help rural companies obtain capital.

Trump: A major focus of the Trump Presidency has been to help address the rural/urban divide. Rural America is home to over 60 million Americans who represent the best of our Nation’s values--hard work, love of country, and embracing freedom--yet oftentimes do not have access to the tools to meet the demands of a growing global economy. It is for this reason that the Trump/Pence Administration has made it a goal to gain access for the 18 million Americans that do not have access to high speed internet. The Trump/Pence Administration has worked to provide more funding through the FCC and USDA’s ReConnect Program to address this key issue. Bridging the internet divide in rural America will help to provide better education, improved telemedicine, as well as give farmers and ranchers more tools to produce our Nation’s food and fiber more profitably. High speed internet access is the lynchpin for the data and technology revolution occurring in agriculture that will benefit farmers and ranchers, the environment and consumers.

Farmers face significant challenges due to the vagaries of weather and other factors that are beyond their control. This can provide enormous stress on farmers and ranchers. For this reason, the Administration has supported increased funding for mental health needs for rural Americans. In addition, the White House has led efforts to address the epidemic of opioid use in rural America.

You can see each candidates answers to other agriculture-related questions below:

Food System Resiliency
Farm Policy Programs
International Trade
Tax Policy
Regulatory Reform
Endangered Species Act
Clean Water
Rural Life and Health
Agricultural Labor
Sustainability and Climate Change