New Farm Action Fund Report Exposes Ashley Hinson DoubleTalk on Rural Healthcare

Report Reveals Iowa to Suffer Heavy Blow to Medicaid Fund due to Big Beautiful Bill while Other States will See Boosts 

MEXICO, MO  — Farm Action Fund today released a new report warning that contrary to Senator Chuck Grassley’s tweet and Ashley Hinson’s claims at yesterday’s debate, rural Iowa’s healthcare will suffer a heavy blow compared to other states as a result of her and other Iowa Republicans such as Rep. Zach Nunn and Rep. Mariannette Miller-Meeks vote for the 2025 Big Beautiful Reconciliation Bill.

The report, The Rural Health Ledger: What Washington Is Giving Rural America May Not Add Up to What It IsTaking Away, examines the federal government’s new highly touted rural health investments alongside the sweeping Medicaid reductions enacted in the Big, Beautiful Bill reconciliation law.

The conclusion is straightforward: federal grants touted by the Trump Administration do not tell rural Americans whether Washington’s overall health-care policies are strengthening or weakening their communities and Iowa stands to lose 16% of its Medicaid fund over the next 9 years. Other states, like Wyoming or Florida, will see a boost in their rural health care funding as a result of the 2025 bill.

“Rural Americans deserve more than Iowa politicians doubletalk on pretending to save rural healthcare by announcing another pot of money,” said Joe Maxwell, author of the report and president Farm Action Fund. “We know rural Iowa’s healthcare system is in crisis with hospital and clinic closures and rural healthcare deserts everywhere forcing farmers to travel long distances for basic care. As our report shows, Ashley Hinson and the other Iowa representatives voting for this bill chose to endanger healthcare access for rural Iowans.”

The federal government recently announced nearly $25 million in direct assistance to 132 small rural hospitals across 13 states, while the $50 billion Rural Health Transformation Program provides $10 billion annually through 2030. Farm Action Fund says those investments are meaningful and should be welcomed.

But they must be viewed alongside the much larger Medicaid reductions.

The Congressional Budget Office estimates the 2025 reconciliation law will reduce federal Medicaid spending by approximately $911 billion over ten years. KFF estimates approximately $137 billion of those reductions will fall on rural areas. The Rural Health Transformation Program, by comparison, provides $50 billion over five years.

According to a 2026 RAND analysis, Iowa received approximately $209 million in first-year Rural Health Transformation funding. Yet RAND projects that Iowa’s Medicaid fund will be $12.8 billion lower by 2034 — a 16.01% reduction from the modeled baseline.

Florida received nearly the same amount of rural transformation funding — approximately $209.9 million — but RAND projects its Medicaid fund will be 0.14% higher by 2034.

Wyoming, meanwhile, received approximately $205 million and is projected to see its Medicaid fund increase by 9.77%, or approximately $1.04 billion.

“Two states can receive virtually the same rural health grant and end up with completely different health-care futures,” Maxwell said. “That is why rural Americans need to see the whole ledger — not just the side of the ledger Washington wants to advertise. And the ledger shows Iowa is going to be a big net loser as a result of Hinson’s vote.”

Farm Action Fund calls for a Rural Health Net-Impact Standard

Farm Action Fund is calling on Congress and the Administration to establish a transparent, nonpartisan Rural Health Net-Impact Standard for major federal health policies.

The standard should provide a state-by-state accounting of:

• Changes in federal Medicaid funding;

• Medicaid enrollment and coverage;

• Rural Health Transformation funding;

• Provider reimbursement and uncompensated care;

• The number and financial condition of rural hospitals;

• Access to emergency, inpatient, maternity and other essential services; and

• Rural health-care employment and economic impacts.

“Washington should be judged by outcomes, not announcements,” Maxwell said. “If federal policy is making rural communities healthier and more economically resilient, show us the numbers. If it is leaving rural families with fewer hospitals, fewer providers and less access to care, rural Americans deserve to know that too.”

Read the full report: The Rural Health Ledger: What Washington Is Giving Rural America May Not Add Up to What It Is Taking Away

Contact: Joe Maxwell, jmaxwell@farmactionfund.us