If you build it, they will come: Rural relocation incentive programs prove popular

In an effort to combat rural depopulation, small communities across the United States are thinking of inventive ways to encourage relocation. Programs have popped up across the country offering financial incentives to new residents, ranging from down payment assistance to cash stipends. These packages can include anything from free internet service and recreation passes to lunch with the mayor. 

An earlier post on this blog discussed how rural communities are attracting California’s remote workers to Indiana incentive programs. This post discusses two programs that have popped up in the last few years since that post that are seeking to draw folks from all backgrounds to find their new rural homes. Both programs offer bigger financial incentives than previous programs and specifically reward homeownership. 

An infrastructure project in Hickman, NE, an hour northwest of Pawnee City.

One program in Pawnee City, Nebraska, a town of about 900 residents, 90 minutes southeast of Lincoln, attracted considerable media attention last year. As part of their Vision 2030 plan, the city is offering $50,000 in down payment assistance to new home buyers. One video on the program from business news service Morning Brew garnered over one million views.  

Over the next five years, the city plans to build 25 houses, multiple apartment buildings, and new community amenities. These projects are set for infill lots already owned by the city, which has helped to reduce costs.  The first two houses will be sold for $325,000, significantly higher than the average home price of $116,768 in Pawnee City. 

But the buzz has proven to be more than just media hype. The Chamber of Commerce reported receiving 115 applications for the two homes in the first two weeks. To qualify, applicants must make no more than 120% of the Area Median Income (AMI). 

Aaron Sawyer, Pawnee City's Economic Development Director, explained to Morning Brew what kind of applicants they are looking for:

The ideal people for these homes that we're building here in Pawnee City would be people that work from home. They can get a lot more bang for their buck to come to a small town like this, in a safe environment, and their same job, and just have a much better lifestyle.

Pawnee City isn't the only place trying to attract the growing number of remote workers to rural areas. Ascend WV is one of the largest relocation programs, covering several rural communities across West Virginia. A partnership between Brad D. Smith, former CEO of Intuit, Governor Patrick Morrissey, the West Virginia Department of Tourism, and the University of West Virginia, this program provides incentives for remote workers to move to the Mountain State for at least two years. 

Maverick's Bar, located in Morgantown, WV, an Ascend WV community.

Ascend WV is offering $12,000 cash payments for relocation, paid out in monthly installments over two years. If participants choose to buy a home at any point in their two years, the remaining money can be paid out as a lump sum for a downpayment or other home-buying expenses. The program also offers free outdoor recreation and gear rentals, access to coworking spaces, professional development through West Virginia University, and exclusive social events.

The program seeks to grow West Virginia's economy while helping remote workers find a community to call home and get involved in. West Virginia recorded the ninth-worst job growth of any state coming out of the pandemic, and post-COVID corporate investment has been concentrated in wealthier-than-average counties. This program could drive spending and tax revenue to more remote locations, like New River Gorge. 

Ascend WV complements First Ascent, a program to support recent graduates of West Virginia University and avoid brain-drain.WVU Today reported that as of September 5, 2025, 

[B]oth programs have drawn nearly 65,000 applicants, relocated upwards of 950 new residents, and kept 60 graduates in West Virginia, boasting above a 96% retention rate. Notably, 38% of participants also are West Virginia homeowners.

It remains too early to tell if these relocation programs are enough to meaningfully combat rural depopulation over the long term. However, these programs have proven incredibly popular and created significant online chatter. Attracting remote workers could pay off considerably, as they are able to increase the tax base and drive up consumer spending, without taking much-needed jobs away from residents. 

The gain isn't solely with the rural community, however. Young people with remote jobs report feeling less happy and engaged in their communities. These programs, especially those that offer social engagement and recreation opportunities, can help people find their place in the world. As twin crises of affordability and loneliness impact young Americans, programs like these may offer a chance for rural areas to revitalize community, reverse demographic trends, and shore up tax revenue. 

 

Sheriffs, sovereignty, and rural governance

In much of rural America, the sheriff is not simply a law enforcement officer but a political actor with broad policymaking power. Sheriffs, like district attorneys, are elected officials who run for office on local platforms. In almost every jurisdiction, sheriffs run the county jail. In rural places where courts are distant and state capacity is limited, the sheriff operates as the face of local governance. In her recent book The Highest Law in the Land: How the Unchecked Power of Sheriffs Threatens Democracy, Jessica Pishko traces the office of the sheriff from its origins to its contemporary role in American governance. Jessica Pishko’s work makes manifest that their power is a product of American legal history.

 The office originated in Anglo-Saxon England, where sheriffs functioned as local agents of the crown, responsible for tax collection. In the United States, however, that model was reshaped during the early nineteenth century.  In the Jacksonian era, the sheriff became an elected official. This move was framed as a democratic improvement on inherited English institutions. Andrew Jackson and his allies sought to expand popular participation in government by multiplying elected offices, imagining the sheriff as a representative of the yeoman farmer and working-class men rather than an arm of elite authority. That historical choice structures the office today, embedding law enforcement authority within electoral politics and helping explain why sheriffs continue to see themselves not only as enforcers of law, but as truest local interpreters.

Control over the county jail is a central source of the sheriff’s authority. As a 2012 blog post, “Rural politics, patronage and (their links to) prisons” identifies, in rural areas, the jail is often one of the largest sources of revenue collection. This reinforces the sheriff's authority and provides strong incentives to expand jail capacity and keep beds filled, especially in rural counties with limited tax bases and alternative sources of public funding. 

Credit: "Summit County Sheriff Ford Taurus Interceptor" by Seluryar is licensed under CC BY-SA 2.0.

The county jail also functions as a central site of policymaking. Tasked with operating county jails, the sheriff makes unilateral decisions about booking, detention, intergovernmental contracts, and immigration enforcement. These decisions take on fiscal significance because the sheriff is not merely enforcing criminal law, but managing an enterprise that directly affects the county’s budget. In this way, jail administration transforms the sheriff into a powerful local political actor whose enforcement choices are inseparable from questions of governance. 

Recognizing sheriffs as political actors helps explain their increased prominence in national politics. Sheriffs run for office every four years, often in off-cycle elections that depress turnout and insulate incumbents. Many sheriffs campaign on political platforms. Association with the Republican Party is a recent and increasingly prominent phenomenon. As Pishko explains, crime and immigration have become central issues in national conservative politics, making sheriffs attractive allies. Within firmly conservative rural counties, the sheriff has embraced its political dimension. 

In interviews and reporting, Pishko documents the rise of the so-called “constitutional sheriff” movement. The movement argues that sheriffs have a special duty to uphold the original Constitution, positioning the sheriff as a bulwark against distant state and federal authority. 

The COVID-19 pandemic brought these dynamics to a head. When governors issued mask mandates and business-closure orders, local enforcement frequently fell to sheriffs. Many sheriffs, especially those in rural areas, were reluctant to enforce the orders. Sheriffs deployed the rhetoric of the “constitutional sheriff,” to justify refusing to enforce these orders. Sheriffs framed themselves as originalist interpreters of the Constitution tasked with protecting private property, gun rights, and religious freedom from elite liberal technocrats. The movement drew energy from longstanding rural anti-government traditions, including militia movements and the sovereign-citizen ideology.

The rise of the constitutional sheriff is a symptom of hollowed out state capacity in rural America. Sheriffs may seem local and accountable, but they wield extraordinary power with minimal oversight. In rural America, the sheriff's office is not simply enforcing the law, it is often deciding what the law will be.

Right to water: Not for California's rural residents?

In 2012, California passed AB 685, becoming the first state to recognize the human right to water. Despite this, as of 2024, over 900,000 California residents get water from water systems that fail to provide them with safe, clean drinking water. 

In 2024, the California State Water Resources Control Board published data showing that 379 of the 457 failing water systems were small water systems with 3,000 or less service connections (often translating to households), mostly located in California's rural agricultural regions in the Central Coast or San Joaquin Valley. Most of these systems rely on groundwater, which may be contaminated with arsenic, nitrate, or 1,2,3-TCP (trichloropropane).

This map shows all of the failing water systems in California that serve a population of less than 5,000. Credit: SAFER Dashboard

San Lucas is a small unincorporated rural community in the Salinas Valley with a population of 324. San Lucas has been on a 'do not drink' order for over 10 years from elevated levels of nitrate in their water supply. The community's wells are located on nearby farmland, where nitrate from crop fertilizer leeches into the groundwater that the well ultimately pulls from. Nitrate consumption has been linked to cancers and pregnancy complications, including "blue baby syndrome."

San Lucas residents are incredibly burdened by the lack of access to clean drinking water. The State provides households with 15 gallons of water per week, but for most families these 15 gallons do not meet their household's needs. Imagine if you are a family of five or six, having to allocate 15 gallons between your family for drinking, cooking, and sometimes even bathing.  

Allotment of water jugs. Credit: Ray Chavez

Residents in San Lucas have complained of skin irritation even from bathing in the water and often choose to bath young children in bottled water, or rinse with bottled water, despite the California Department of Public Health saying that babies can be bathed in nitrate contaminated water. Most residents drive to King City (10 miles away) to buy bottled water to supplement the allocated bottled water, and still have to pay their water bill for unsafe water. 

Access to safe drinking water is an ongoing problem. The Safe and Affordable Funding for Equity and Resilience Program (SAFER) was established in 2019, allocating $130 million each year, to provide a funding source for operation and maintenance costs, consolidation projects, replacement water, and funding for administrators. Since 2019, SAFER has provided $700 million in grants for small, disadvantaged communities in California. While SAFER was originally set to end in 2030, in 2025 the California legislature extended the yearly allocation of funds to 2045.

San Lucas has spent years trying to figure out the solution to their problem. The community has received a little over half a million dollars in technical assistance funding from the SAFER program. This money has funded a study of solutions, with alternatives including an 8 mile pipeline to King City, two different well-head treatment systems, and building a new well. 

In June of 2025, the San Lucas County Water District (the small company providing water to San Lucas) voted to pursue alternative four, build a new well. But building a new well comes with its own uncertainties. 

As Paul Hamann has previously discussed on the blog, rural landowners of private domestic wells are facing the ongoing problem wells drying up due to over-pumping. Private domestic wells provide water to between 1.5 and 2.5 million California residents, but are not regulated by the state. If you own a private domestic well, you are responsible for testing for contaminants to ensure that it is safe to drink. 

While any new well built by San Lucas would still be a part of a water system regulated by the state, they undoubtedly will face the same uncertainties of ensuring that their well does not run dry. Seemingly even more pressing, how can San Lucas ensure that their new well does not face the same fate as the current wells? Surrounded by agriculture, it seems like a tall task to find a location to drill a new well safe from nitrate contamination. 

Whatever path ends up being taken, there is no doubt that these communities, especially San Lucas, need clean drinking water, and they needed it ten years ago. While the State Water Board may tout that 98% of California's have clean drinking water, we cannot choose to neglect 2% because of their location in rural areas. 

The changing Chinese attitude towards the rural

I was born in Shanghai at the turn of the century in Zhongshan Park, rooted in the heart of Shanghai. In the 1930s, my grandfather watched as the roots of the first international port in China shot off into a burgeoning international hub. Following WW2, my father watched factories churn out concrete and asphalt onto the packed dirt and cobblestone streets of the city as the rapid industrialization of China choked out any surviving remnants of Imperial China.

 

    Old Shanghai Circa 1960s

By the time I was born, modern Shanghai had been presented to the world, a true “global” city by the metrics of international research impact and the size of its economy, China’s New York and London wrapped into one neon package. In the twenty years since, it has only grown, the bright skylines on both sides of the Huangpu River, Puxi and Pudong, divided in appearance only by the living memory and history of Pudong’s more humble origins.

View landing into Shanghai Pudong International Airport, Oct 2025

  The Bund, Shanghai, Oct 2025

In the day of my father, the city was the desired end goal, the only location where the rapidly industrializing China could be experienced by the formerly agrarian subsistence farmers that had always comprised the bulk of China. The city was where any enterprising person could get rich, the gateway to the unimaginable international world. A hukou (a little more about that from Professor Pruitt and the Economist) in the city was the most desirable to be able to get the exclusive social services only allowed for the residents of the city.

And yet, core to the Maoist uplifting of the “pure” agrarian proletariat was the belief that the city cultivated pro-bourgeois sentiments, and from the 1950s to the 1970s, the urban youths were all sent to countryside (a collection of photos detailing the Back to the Countryside Movement collected by Dartmouth here) in the belief that the hard living of rural life would leave them firm believers of social equality, as well as build the toughness that only farming and ranching builds (A little more on that from Professor Pruitt).

At the time, the idea to stay in the communes was unthinkable, the whole experience an experience in the same type of biting poverty that they had lived through during the revolution. In many respects, the rural people were the same people as the impoverished peasantry that had long suffered. In some parts of China today, any reference to the mountains still carries the old reference to the impoverished villages that remain in those areas (a la hillbillies). The food of such areas remains directly translated as “dirt food” or peasant food.

Today, however, there is a growing counterculture, two generations after the boom. Rising costs in the city make finding a job, buying an apartment, starting a family prohibitively expensive for graduates of even the most elite universities. Rising youth employment (near 20%)  reveals the worst job market China has ever seen (A slight improvement in this new 2026 quarter by South China Morning Post). Even given the opportunities of the urban environment, the struggle and competition itself can be overwhelming even for those that grew up with it.

Growing numbers of Chinese youths seek to escape to the rural, rather than continue in the struggle of urban life. This trend continues even with the loosening restrictions among the obtaining of a hukou, and the courting of these new exurban residents to new cities.

As The Economist points out:

It had taken just two generations for a Chinese family to pass from pre-industrial agrarianism to post-material urban malaise

In this the Chinese and the Americans are now more similar than different. As China’s growth slows down as America's did in the 1980s, and the glow of the urban lights stings more than it inspires, with it will come the nostalgia for what is gone. When the struggles of poverty are removed, only the admittedly beautiful view remains.

  My Mom's hometown, now a highway, circa 2010s

Rural tourism: a double-edged sword

Summer Hike 2025 - Kīholo Bay, Big Island, HI 

Where tourists vacation, money often flows: lodging bookings increase, more jobs are created, and the beauties of rural communities are discovered. The reality, however, is that the people and places making money aren't always the ones paying the price for over-tourism. Within this context, people like environmentalist Hanan Kouli are part of a movement supporting rural tourism. 

Kouli explained the significance of tourism to rural economies in places like Hawaii, and the need for a more sustainable approach, stating:

...[M]any residents rely on [tourism]...The problem isn't tourism, it's too much tourism without enough care. 

As someone from a rural island community, it's encouraging that tourists and locals alike recognize the harms of mass tourism, even though it can also be a double-edged sword. Without increased community control, rural tourism can reproduce the same harms as mass tourism - displacement and cultural commodification - albeit with better branding than mass tourism. 

What is rural tourism? 

Rural tourism occurs in non-urban areas and is considered a sustainable alternative to mass tourism. A 2015 blog post put it even more simply, defining rural tourism as: 

...[T]he country experience [with] opportunities for visitors to directly experience agricultural and/or natural environments. 

I felt the appeal of that "country experience" while staying on a farm in New Zealand. Even then, it was clear that rural areas were still recovering from COVID-19's impact on the tourism industry. Indeed, especially after COVID-19, one benefit of rural tourism is attracting more tourists like me, who seek rural destinations to avoid large crowds and experience a different way of life.

Farm Stay 2024 - New Zealand

What are the benefits of rural tourism?

At its best, rural tourism can broaden the local economy by keeping income streams rooted in rural communities instead of flowing from (or towards) urban centers. The promise is simple: jobs and demand for local businesses in rural areas. According to a 2023 article from the journal for Humanities & Social Sciences Communications, rural tourism:

...[Promotes] rural community development and...could counteract the negative impacts of urbanization.

Hawaii offers an illustration of how that can play out. Tourism is the state's largest economic driver, but the benefits are most visible when tourism dollars circulate through rural communities, rather than resorts. This is particularly true in rural areas that offer  "authentic" island experiences, like the Polynesian Cultural Center (PCC), Hawaii's top-paid tourist attraction. 

Mariott Resort 2024 - Ko'olina, Oahu

However one views it culturally, PCC channels visitor spending into the rural community where it operates - supporting jobs, and for many workers, substantial college scholarships. 

Sadie's Inn 2025 - Utulei, American Samoa

Similar dynamics show up in my home country of American Samoa. Tourism helps offset the country's financial reliance on its tuna processing plant - Starkist - which makes up about one-third of its workforce. Rural attractions like the National Park and Ofu Beach draw tourists whose spending supports lodging, food service, and cultural education.

My criticisms of rural tourism

My gripe with rural tourism is rooted in concern about what happens to "authenticity" once it becomes the selling point. What was once authentic is often changed to meet consumer expectations rather than community needs. That was the dynamic Professor Lisa Pruitt described as "faux rural" in her 2013 blog post. 

Sapphire Princess 2023 - Pago Pago, American Samoa

The trade-off of living in a highly marketable rural "paradise" is that it can make you feel like you're always on display. When tourists arrive expecting a specific version of island life, the pressure to look the part increases. A 2023 study on the Socio-Cultural Effects of Rural Tourism observed that 

...[T]he development of tourism in rural communities has the potential to produce unwanted socio-cultural consequences.

I felt that dynamic early. As a child, I remember giving staged performances for tourists. Those dances weren't fake, but over time, the performance mindset skewed my perception of "authenticity."  

So, what now?

I can't deny the economic benefit that rural tourism has brought to rural communities, mine included. I still see it as a bridge between the "urban-rural" divide discussed in Professor Pruitt's 2024 blog post. The goal isn't to eliminate tourism; it's to shape it on community terms. 

What does this look like? Perhaps restrictions on short-term rentals, visitor caps, or local hiring requirements. In any case, increased community control is essential to stop rural tourism from reproducing the same harms as mass tourism.

Big tech sets its sights on rural Arizona

The blog’s most recent post discussed the Rural Health Transformation Program. Passed as part of Trump’s “One Big Beautiful Bill,” this “rural slush fund” was added as a last-minute sweetener to secure the support of Alaska Senator Lisa Murkowski.

One of the $50 billion fund’s stated goals is “tech innovation.” States utilizing the funds must spend them on three or more approved uses, including:

Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.

This sounds promising. Rural hospitals face unique challenges, and technology that improves care and increases capacity could be transformative. An earlier post on this blog discussed how RFK Jr. has promoted AI nurses as a potential solution to the rural health care crisis. That optimistic vision contrasts sharply with how artificial intelligence is currently arriving in many rural areas.

In December 2025, Sharon Goldman reported for Fortune on a massive AI data center project planned for rural Arizona. The development would be built on a 2,000-acre property called Hassayampa Ranch, located about 50 miles west of Phoenix near the unincorporated community of Tonopah in western Maricopa County. The area is home to a few hundred residents, drawn there for its tranquility and clear skies for stargazing.

Photo caption: Buckeye Ranch, Tonopah. © Nextdoor

This quiet corner of the desert has become the center of intense activity since developer Anita Verma-Lallian purchased the land for $51 million, backed by billionaire venture capitalist and Trump mega-donor Chamath Palihapitiya. The plan is to spend as much as $25 billion to build a data center that would produce 1.5 gigawatts of compute and consume as much electricity as a million homes.

Photo caption: Visualization of the land parcel. © Jason Ma, 2025

Investment in rural communities sounds exciting, but who benefits? As Andrew Aitken noted in The Builder Bureau, AI is largely being developed for and used by urban populations, while rural people continue to struggle with poor network coverage and slow internet speeds. So while it remains unclear whether Tonopah will reap any benefits from hosting AI infrastructure, residents are already bearing the costs.

This pattern echoes concerns raised in prior entries on this blog. A May 2024 post discussed how rural folks in Montana are resisting efforts to make their land a “carbon sponge” for urban America. As one county commissioner put it:

The question I keep hearing is, ‘Why are they making us the dumping ground for the rest of the country?’

A similar dynamic is at play in Tonopah, with rural Arizona poised to bear the environmental burden of infrastructure that primarily serves urban tech consumers.

In her Fortune article, Goldman explains that Tonopah residents are already worried about incoming noise and light pollution, traffic and infrastructure strain, and negative impacts on property values. Concerned community members have organized and signed petitions against the development. But with such a small population, their political power is limited against billionaire-backed interests. As Kathy Fletcher, a 76-year-old resident who lives on a one-acre plot next to the Hassayampa Ranch site, said:

All we can do is plead with the people here... We’re kind of treated like the redheaded stepchild, and they just think they can throw anything they want out here... We’re having a difficult time fighting the battle to tell people, ‘You can make a difference.’

Another major concern is water. AI data centers generate vast amounts of heat and require millions of gallons of water per day for cooling. According to the Environmental and Energy Study Institute, a medium-sized data center can consume up to 110 million gallons of water per year—equivalent to the annual water usage of approximately 1,000 households. Larger data centers can use up to 5 million gallons per day. For the people of Tonopah, who rely almost exclusively on ground wells for their water needs, the prospect of a massive development tapping into their water supply is daunting.

As Dillon Beckett wrote on this blog, utility-scale projects are “overwhelmingly sited in rural areas” and tend to “benefit a sliver of the community’s social strata (wealthy, often absentee landowners, with extensive real estate holdings) while spreading the cost across the entire community.” The Hassayampa Ranch data center fits this pattern: Silicon Valley investors stand to profit, while local residents face rising utility costs, depleted aquifers, and a transformed landscape.

Tonya Pearsall, a Tonopah resident who has lived in the area since 1999, feels a profound sense of loss as this project rapidly changes the character of her once-calm community:

We used to be able to see the Milky Way—that’s why we moved out here... It’s painful... I could break down and cry.

Photo caption: The night sky over Maricopa County. © David Iversen, 2025.

There is some movement in Congress to address these concerns. Representative Jim Costa (D-CA) has introduced the Unleashing Low-Cost Rural AI Act, which would require the Departments of Agriculture, Interior, and Energy to study the impact of AI data center expansion on rural areas, including effects on energy supply, consumer costs, and infrastructure needs. Whether such a study will lead to meaningful protections for communities like Tonopah remains to be seen.

The Hassayampa Ranch project is not unique. Similar fights are playing out in Louisiana, Wisconsin, and Georgia, where rural residents are pushing back against data center proposals that promise economic development but threaten local resources and quality of life.

As AI continues its rapid expansion, rural communities across the country will increasingly find themselves on the front lines of a familiar struggle: who decides what happens to rural land, and who bears the cost of progress?

Rural health "slush fund" distributions announced

Fall River Mills, California
(c) Lisa R. Pruitt 2018

The Centers for Medicare and Medicaid Services announced this week the establishment of the Rural Health Transformation Program in relation to Trump's "One Big Beautiful Bill" passed in July--and the so called "rural slush fund" that was a last-minute addition to that law.  An earlier post about that late addition to the law is here, also noting that it was added in part to secure the vote of U.S. Senator Lisa Muskowski's (Alaska) support for the law.  

The Rural Health Transformation Program website touts it as 

empower[ing] states to strengthen rural communities across America by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem. Through innovative system-wide change, the RHT Program invests in the rural healthcare delivery ecosystem for future generations.

Its stated goals are: 

• make rural America healthy again
• sustainable access
• workforce development
• innovative care
• tech innovation

At the end of this post, I cut and pasted from this website more information about the structure and requirements.  For now, however, I want to focus on details of the distribution.  First, all states got a share of the distribution,  and the states that fared best were Texas, Alaska, California, Oklahoma and Montana.  That said, the award amounts to the states did not vary dramatically.  The average amount awarded to each state was $200 million, with the range from $147 million (New Jersey) to $281 million (Texas).  Here's an excerpt from the CMS announcement of the awards, which went to all 50 states.  

This unprecedented federal investment will help states expand access to care in rural communities, strengthen the rural health workforce, modernize rural facilities and technology, and support innovative models that bring high-quality, dependable care closer to home.

It includes this long quote from Health and Human Services Secretary Robert F. Kennedy, Jr.:  

More than 60 million Americans living in rural areas have the right to equal access to quality care.  This historic investment puts local hospitals, clinics, and health workers in control of their communities’ healthcare. Thanks to President Trump’s leadership, rural Americans will now have affordable healthcare close to home, free from bureaucratic obstacles.

It also features this direct quote from Dr. Mehmet Oz, the CMS administrator:  

Today marks an extraordinary milestone for rural health in America. Thanks to Congress establishing this investment and President Trump for his leadership, states are stepping forward with bold, creative plans to expand rural access, strengthen their workforces, modernize care, and support the communities that keep our nation running. CMS is proud to partner with every state to turn their ideas into lasting improvements for rural families.

Roll call covered the matter, with a focus on Texas.  Some key excerpts follow: 

Twenty percent of [a state's] score [on the application for the competitive part] was determined by a state’s policy actions, including vows to pursue waivers to ban SNAP users from buying certain items like soda and candy, reinstating the presidential fitness test for schoolchildren and requiring that medical schools teach students about nutrition, among other things. States could lose money in future years through a “rescoring” process if they don’t follow through on those initiatives, Oz said.

The remaining 30 percent is based on the strength of the ideas that states proposed in their applications.

Projects highlighted by CMS on Monday include ones that aim to expand access to preventative, primary, maternal and behavioral health care. States also are pursuing “food as medicine” initiatives, models to address chronic disease prevention and programs to shore up their health care workforce.

Critics had argued the amount of funding available is nowhere near large enough to offset reductions in federal Medicaid spending made by the reconciliation law, which amounts to $911 billion over 10 years. Sen. Susan Collins, R-Maine, who voted against the bill, had pushed for at least $100 billion in rural health funding.

The $50 billion would offset only about 37 percent of the estimated loss of federal Medicaid funding in rural areas, according to KFF, a health policy research organization.

But Dr. Mehmet Ozi is quoted as saying the funding is not intended to offset the reductions:  

The purpose of this $50 billion investment in rural health care is not to pay off bills.  The purpose of this $50 billion investment is to allow us to right-size the system and to deal with the fundamental hindrances of improvement in rural health care.

This excerpt from PBS Newshour coverage hits more squarely at the politics of the matter and what the Trump administration's CMS is trying to accomplish with these awards in relation to its wider "Make America Healthy Again" agenda: 

Several Republican-led states — including Arkansas, Iowa, Louisiana, Nebraska, Oklahoma and Texas — have already adopted rules banning the purchase of foods like candy and soda with SNAP benefits.

The money that the states get will be recalculated annually, Oz said, allowing the administration to "claw back" funds if, for example, state leaders don't pass promised policies. Oz said the clawbacks are not punishments, but leverage governors can use to push policies by pointing to the potential loss of millions.

"I've already heard governors express that sentiment that this is not a threat, that this is actually an empowering element of the One Big Beautiful Bill," he said.

Carrie Cochran-McClain, chief policy officer with the National Rural Health Association, said she's heard from a number of Democratic-led states that refused to include such restrictions on SNAP benefits even though it could hurt their chance to get more money from the fund.

"It's not where their state leadership is," she said.

Next, I quote from the analysis of a rural health care consultant working out of Texas, which came across my LinkedIn feed: 

Just reviewed the state allocations from CMS’s landmark $50B Rural Health Transformation Program, and the per‑rural‑person math is fascinating. I'm a CPA and I love excel...so you know I had to create my end of year fun facts related to the CMS awards for RHTP.

If you missed the announcement, here is a link to the full article. 

For context, the average award across all states is $1,957 per rural person.
Texas received $329 per rural person — a solid, meaningful investment in our rural communities. 

N.B.   It is not clear how this consultant is defining "rural" for purposes of these calculations.  

To put that in perspective:
Rhode Island: $31,525 per rural person
Just above Texas: Ohio ($345), NC ($360), PA ($390), MI ($413)
Next tier below RI: NJ ($5,343), AK ($4,949), MA ($3,332), DE ($3,231)

Texas’s total award is $1.4 billion over five years — the largest in the country. While we weren’t guaranteed the top spot, the hard work by the Texas team at HHSC on the application positioned us to lead in rural innovation.

I was personally hoping for closer to $2.1B, but we’ll take this $1.4B and put it to work transforming the rural health landscape across Texas. Huge congratulations to the HHSC team and all our partners who made this possible.

Here’s to an innovative, data‑driven 2026 and beyond for rural Texas! 🌟

Finally, I'm pasting here the details on the program (as promised above), which is essentially the call for applications: 

Program Structure

RHT Program funding is $50 billion to be allocated to approved States over five fiscal years, with $10 billion of funding available each fiscal year, beginning in fiscal year 2026 and ending in fiscal year 2030.

• 50% to be distributed equally amongst all approved States
• 50% will be allocated by CMS based on a variety of factors including rural population, the proportion of rural health facilities in the State, the situation of certain hospitals in the State, and other factors to be specified by CMS in the NOFO

Uses of Funds

States must use RHT Program funds for three or more of the approved uses of funds:Promoting evidence-based, measurable interventions to improve prevention and chronic disease management.

• Providing payments to health care providers for the provision of health care items or services, as specified by the Administrator.
• Promoting consumer-facing, technology-driven solutions for the prevention and management of chronic diseases.
• Providing training and technical assistance for the development and adoption of technology-enabled solutions that improve care delivery in rural hospitals, including remote monitoring, robotics, artificial intelligence, and other advanced technologies.
• Recruiting and retaining clinical workforce talent to rural areas, with commitments to serve rural communities for a minimum of 5 years.
• Providing technical assistance, software, and hardware for significant information technology advances designed to improve efficiency, enhance cybersecurity capability development, and improve patient health outcomes.
• Assisting rural communities to right size their health care delivery systems by identifying needed preventative, ambulatory, pre-hospital, emergency, acute inpatient care, outpatient care, and post-acute care service lines.
• Supporting access to opioid use disorder treatment services (as defined in section 1861(jjj)(1)), other substance use disorder treatment services, and mental health services.
• Developing projects that support innovative models of care that include value-based care arrangements and alternative payment models, as appropriate.
• Additional uses designed to promote sustainable access to high quality rural health care services, as determined by the Administrator.

This KFF Health News site tracked the states' applications for these funds.  

NYT feature on the consequences of California redistricting on rural northstate

Kellen Browning reports for the New York Times under the headline, "They Wanted a Conservative State. They Might Get a Democratic Representative Instead."  The story is a richly textured look at how the residents of far northern California feel about the November passage of Proposition 50, which adopted new congressional districts that will temporarily override the decisions of the state's independent redistricting.  As I've written about previously here, here, here and here, this means residents of the current District 1, an inland district stretching from Butte County, about 80 miles north of Sacramento, all the way to the Oregon state line, are likely to be represented by a Democrat after the 2026 midterm elections.  This is because parts of current District 1 will be combined with a strip of coastal wine country stretching down into Marin County, just north of San Francisco.   The current 1st District is shown in lavender in the map below.  Much of it will be subsumed into a new 2d District, outlined by the dotted orange line. 

Source: We Draw the Lines California, California Legislature
Credits: Jeremia Kimelman, CalMatters

Excerpts from Browning's story follow.  Some highlight rural-urban difference and others highlight the feelings of rural voters in California' north state.  

For decades, residents in the rural north have longed for a political earthquake that would cleave their region out of California and allow them to create their own fabled “State of Jefferson” with conservatives in Southern Oregon. They have increasingly felt underappreciated and misunderstood by the liberal Democrats who run California and dominate the congressional delegation — who, in their telling, siphon away their water and prioritize environmental regulations that undercut farmers’ livelihoods.

Now, they not only lack a conservative State of Jefferson, but their entire region is also likely to lose its Republican congressman and have him replaced by a Democrat after next year’s midterm elections. 

“People in the cities don’t have a clue what it takes to survive out here,” said Terry Williams, a 75-year-old rice and walnut farmer who moved to Richvale in 1974. “I don’t think people that were born and raised in the cities can represent us to the same extent.”

Here's a quote from Gene Lifur, a 52-year-old from Orland, population 8,2998, which claims to be the "Queen Bee Capital" of North America for its role in raising the pollinators:  

There was definitely a feeling of throwing up your hands.  You’re going to lose a lot of the interest for voting in the North State.

Another resident, DaNell Millerburg, 62, who manages the Richvale Cafe, "said the idea of her small town being represented by someone from the Bay Area was 'scary.' ...'They want to save the opossums and the beavers and the snakes.  But it’s not good for the farmers, because those animals dig holes in their ditches.'"

Browning meet many of those he interviewed at the cafe, "a nonprofit kept afloat by locals, who wanted to ensure that the area’s solitary farmers had a place to meet."  Richvale, population 234, is the home of current District 1 Congressperson Doug LaMalfa who asserted, "I understand people here far better than a Bay Area interloper."

Rural residents, Mr. LaMalfa said, grew crops enjoyed by California’s cities but were scorned by those living in cities. He said that Democrats were passing expensive pollution regulations, tearing down crucial dams in the name of protecting salmon populations and introducing wolf packs that attacked their herds. Proposition 50 was the latest affront.

“Their voice is being silenced on how they feel about the issues here, because Newsom and the three-to-one ratio of Democrats wanted to see if they could steal five seats,” Mr. LaMalfa said of the governor and state lawmakers.

* * *

“I’m furious,” [LaMalfa] added, “because I’ve had my people kidnapped from me.”

* * *

The Democrats running against Mr. LaMalfa agreed that rural Californians have been neglected by many in their party. But they also argued that Republicans like Mr. LaMalfa have hurt farmers and agrarian communities with their policies.

Those Democrats include Mike McGuire of Geyserville, in Sonoma County, who until recently was president pro tem of the California Senate, and Audrey Denney, who grew up on a coastal cattle farm but has lived and worked for 20 years in Chico, a college town in the same county (Butte) as Richvale.  Denney has already run twice, unsuccessfully, against LaMalfa.  McGuire's California Senate district stretches from Sonoma County all the way to the Oregon state line, but hugs the coast, a more progressive region.  I have observed over the years that he takes the needs of his region's very rural reaches very seriously.  Read about that here and here.  Denney will presumably vie to represent the new 1st District, and McGuire will seek to represent the new 2d District.  

I'll close with this quote from another resident, Chris Culp, 62, a retired Navy officer, who Browning found at the Last Stand Bar and Grill:  

Somebody from Santa Rosa, Oakland, they’re not going to understand, and honestly I don’t think they’re going to take the time to get educated about what’s going on up here.  We’ve got different needs than the people in the dense cities and the coast.

Other posts highlighting the different needs of rural and urban California and long-standing agitation related to the would-be State of Jefferson are here.   

New Hampshire (once again) tries to restrict student voting (Part IV): documents, documents, and more documents

This is Part IV in my look at New Hampshire's history of attempting to disenfranchise college student voters. For Part I, which provides essential background information, please click here. You may read Part II here. You may read Part III here. 

"A resident or inhabitant or both of this state and of any city, town, or other political subdivision of this state shall be a person who is domiciled or has a place of abode or both in this state and in any city, town, or other political subdivision of this state, and who has, through all of his or her actions, demonstrated a current intent to designate that place of abode as his or her principal place of physical presence [for the indefinite future] to the exclusion of all others."

                                                                                                - New Hampshire House Bill 1264

In July 2018, New Hampshire governor Chris Sununu signed a bill into law that amended the state's definition of "resident" for the purposes of voting. Despite a federal court clarifying that students could vote in the state and compromises being reached to make that happen, there were still some who felt that students were simply not welcome at the ballot box. On this day, those interests won. 

Prior to this change, an intent to remain in the state "indefinitely" was sufficient to be considered a resident for voting purposes. In practice, this shift in definition would effectively force out of state college students to get New Hampshire driver's licenses and register their vehicles in the state. Since these things cost money, these new requirements essentially amounted to a poll tax. Just as they had in 1971 and 1972, the New Hampshire chapter of the American Civil Liberties Union came out against the legislation and filed a lawsuit to stop it from going into effect. 

Widespread Opposition 

The bill had passed despite widespread opposition and warnings that it would disenfranchise college students. In fact, the original venue for the bill's July hearing before the Senate Election Law and Internal Affairs Committee was insufficient to hold the people who had turned up to oppose the bill. College students, facing disenfranchisement, showed up to show their opposition.

Many opponents zoomed in on the removal of intent to remain "indefinitely" from the state's election laws. While a federal court later ruled it was unnecessary, even the most ardent opponents of student voting in 1972 agreed that a statement of intent to remain indefinitely was sufficient. This legislation upended a status quo that had essentially persisted for the last 45 years.

SB 3 and the Turn Toward Enforcement

As a voter suppression effort, HB 1264 did not stand alone. It built directly on Senate Bill 3 signed into law the previous year. SB 3 altered the mechanics of voter registration by requiring voters who registered without documentation to complete detailed affidavits and submit proof of residency either at the polls or through post-election follow-up. Those who failed to provide documentation in a timely manner faced civil penalties and the possibility of criminal prosecution.

SB 3 did not explicitly target college students, but its effects fell most heavily on them. Students, who are more likely to register close to Election Day and less likely to have New Hampshire-specific documentation on hand were transformed from presumed eligible voters into legal risks. Civil rights groups warned that SB 3 converted routine voter registration into an act that could trigger investigation by the Secretary of State or referral to the Attorney General.

The New Hampshire Civil Liberties Union, along with other voting-rights advocates, sued to block SB 3’s enforcement. In October 2018, just weeks before the midterm election, a state court issued a preliminary injunction preventing the law’s new registration forms and enforcement provisions from being used. The court concluded that SB 3 imposed unreasonable burdens on the right to vote and risked confusion and disenfranchisement at polling places.

That injunction foreshadowed SB 3’s eventual demise. In 2021, the New Hampshire Supreme Court struck the law down in its entirety, holding that it violated the state constitution by placing disproportionate burdens on eligible voters without evidence of a meaningful fraud problem.

HB 1264, by contrast, survived judicial scrutiny. Because it altered definitions rather than election-day procedures, it was treated by courts as a permissible legislative clarification rather than an immediate burden on voting. The result was an uneven legal landscape: SB 3, which enforced residency claims at the polls, was enjoined and invalidated; HB 1264, which raised the cost and risk of making those claims in the first place, endured. 

After the New Hampshire Supreme Court issued a favorable advisory opinion regarding HB 1264, the lawsuits that sought to overturn it were withdrawn. It still stands to this day. The residency requirements imposed by HB 1264 survived, but the documentation requirements imposed by SB 3 did not. A college student registering to vote today may prove their identity and residency using documents provided by their college, satisfying the requirements of HB 1264.

Both laws were passed under the familiar banner of “preventing fraud.” In reality, they reflected a sustained effort to narrow the electorate by making student participation more expensive, more confusing, and more legally fraught.

The Broader Effort

Taken together, these measures represented the culmination of a long-running partisan effort to suppress the political power of those who live in New Hampshire but are not considered permanent enough to be trusted with a ballot. College students are undeniably present in the state for most of the year, and many will never return to their so-called “home” communities after graduation. Forcing them to vote in those communities compels them to participate in elections where the consequences of public policy may never touch them, while silencing them where those consequences most certainly will.

Part V, which will come next year, will examine the most recent updates.

CalMatters does deep dive into flat-fee contracts for indigent defense

Anat Rubin reports today for CalMatters, the non-profit news service, under the headline, "The Walmart of Public Defense:  How Justice Gets Sold to the Lowest Bidder in Rural California."  Here's an excerpt: 

For three years, the fate of poor people accused of crimes in San Benito County lay in the hands of attorneys who barely spoke with their clients and seldom filed legal motions on their behalf.

While defendants asked them to contest the prosecution’s evidence, to interview witnesses, to do anything, really, to challenge law enforcement’s narrative of the crime, they ushered almost all of them to plea deals instead, averaging just one jury trial for every 1,500 cases.

The attorneys worked for Fitzgerald, Alvarez and Ciummo, the firm that San Benito paid to provide public defense. According to a 2024 state evaluation, they were not doing a good job. Two of the attorneys had inappropriate relationships with clients, another struggled with addiction.

The situation had deteriorated so dramatically that the San Benito district attorney, Joel Buckingham, found himself worrying about the people his office was trying to send to prison. Their attorneys didn’t contest the evidence Buckingham’s prosecutors presented, no matter how it was obtained. Each year, they filed an average of just 10 motions to suppress evidence based on violations of constitutional rights — including unjustified stops and searches, illegal interrogations, and arrests without probable cause.

“Police officers must make mistakes sometimes,” Buckingham told a researcher conducting the evaluation.

The sheriff, Eric Taylor, was also alarmed. If his deputies were never challenged in court, how would they know when they had crossed a line? What would stop them from doing it again?

In Taylor’s previous job, in Santa Cruz County, the courthouse was often packed with law enforcement officers who had been called to defend their actions.

“If we’re doing our job correctly, then we prevail on those motions,” he told San Benito county supervisors last year. “And if we’ve made a mistake, and we’re doing our job incorrectly, we’re held accountable for that.”

Nearly half of California counties pay private lawyers and firms to represent poor people in criminal cases, and most of them, like San Benito, do it through what’s known as a “flat-fee” contract, meaning they pay a fixed amount, regardless of how many cases the attorneys handle or how much time they spend on each case.

It’s a far cheaper alternative — at least in the short run — to operating a public defender office with government lawyers, and it’s created a second-tier justice system in rural stretches of the state: Seven of the eight counties with the state’s highest jail and prison incarceration rates have flat-fee contracts.

You can read the rest of this deeply reported story here.  Read my own scholarship about rural indigent defense delivery here (Yale Law Journal Forum, about how these issues play out in Washington State) and here (Arizona Law Review, about Arizona).  

Congress (finally) renews Secure Rural Schools Act, through 2027

Congress voted overwhelmingly yesterday to renew the Secure Rural Schools Act.  Here's an excerpt from the Los Angeles Times coverage, by Hailey Branson-Potts, which leads with a bit historical perspective on rural schools lobbying efforts for the funding over the past few years:  

In February 2023, Jaime Green, the superintendent of a tiny school district in the mountains of Northern California, flew to Washington, D.C., with an urgent appeal.

The Secure Rural Schools Act, a long-standing financial aid program for schools like his in forested counties, was about to lapse, putting thousands of districts at risk of losing significant chunks of their budgets. The law had originated 25 years ago as a temporary fix for rural counties that were losing tax revenue from reduced timber harvesting on public lands.

Green, whose Trinity Alps Unified School District serves about 650 students in the struggling logging town of Weaverville, bounded through Capitol Hill with a small group of Northern California educators, pleading with anyone who would listen: Please renew the program.

They were assured, over and over, that it had bipartisan support, wasn’t much money in the grand scheme of things and almost certainly would be renewed.

But because Congress could not agree on how to fund the program, it took nearly three years — and a lapse in funding — for the Secure Rural Schools Act to be revived, at least temporarily.

On Tuesday, the U.S. House overwhelmingly voted to extend the program through 2027 and to provide retroactive payments to districts that lost funding while it was lapsed.

The vote was 399 to 5, with all nay votes cast by Republicans. The bill, approved unanimously by the Senate in June, now awaits President Trump’s signature.

“We’ve got Republicans and Democrats holding hands, passing this freaking bill, finally,” Green said. “We stayed positive. The option to quit was, what, layoffs and kids not getting educated? We kept telling them the same story, and they kept listening.”

Green, who until that 2023 trip had never traveled east of Texas, wound up flying to Washington 14 times. He was in the House audience Tuesday as the bill was passed.

In an interview Tuesday, Republican Rep. Doug LaMalfa, who represents a vast swath of Northern California and helped lead the push for reauthorization, said Congress never should have let the program lapse in the first place.

I don't agree with LaMalfa on many issues, but on this one he is absolutely correct.  

The five congresspersons who voted against the Act were: 

• Rep. Andy Biggs (R-AZ)
• Rep. Paul Gosar (R-AZ)
• Rep. Anna Paulina Luna (R-FL)
• Rep. Thomas Massie (R-KY)
• Rep. Ralph Norman (R-SC)

Here is an Ed Source story about the passage of the law, and here's an Oregon Public Broadcasting story focused on the significance of this funding to many counties in the Pacific Northwest.  CalMatters covered it here.  An announcement by New Mexico Congressman Gabe Vasquez, who says it means $9 million for his state's rural schools, is here. 

Finally, here is a February 2023 post based on Branson-Potts' previous story about California rural school administrators lobbying in Washington, D.C., for the Secure Rural Schools Act.   The term used there for the pittance represented by this spending--at least from the perspective of all federal spending: "budget dust."