When lawmakers return to Washington, D.C. from their April recess, I don’t have a good feeling about what’ll come next. They’ll begin the process of budget reconciliation, and it doesn’t bode well for rural America. Just look at the budget resolutions they passed before leaving town.

Of particular concern is $880 billion cuts from Medicaid. There’s just no way you can do that without cutting benefits. Those cuts won’t just hurt the folks on Medicaid, it’s going to hurt our rural hospitals, nursing homes, and health facilities.

Medicaid covers about 300,000 Iowa kids. It disproportionately covers people with disabilities, low-income elderly, and folks needing long-term care. And it fills in the gaps for millions who need mental health and nursing home services not covered by private insurance.

I’m sure we’ll hear something along the lines of “able-bodied adults should be working.” Well, 92 percent of able-bodied Medicaid enrollees already work either full-time or part-time, are in school, or have caregiving responsibilities.

They’re not going to find “savings” in Medicaid. They’re going to cut it, and we’ll feel the effects. Medicaid is a significant source of revenue for our rural hospitals. A February report from the National Rural Health Association stated “nearly 50% of rural hospitals operate with negative margins.” If we lose more of our hospitals, we lose our businesses and more. Here in Greenfield, Cardinal Glass would never have established itself without having a hospital available.

But it’s not just Medicaid in their sights. The House’s budget plan directs the Agriculture Committee to find $230 billion in cuts. SNAP is housed under the USDA. So they’re coming for our healthcare and our food! Like Medicaid, they’ll say things like the states need to put some skin in the game through a “state match.” That’s a recipe for disaster for states with tight budgets.

States and the federal government split the administrative costs of SNAP, with the feds covering the entirety of the benefits. I don’t see a scenario where our current leaders would fully fund SNAP while they prioritize tax cuts for the rich. But farmers, grocers, even retailers like Walmart benefit from SNAP. Cut SNAP and grocers will close and food banks will struggle to meet the need. It’ll be like when CCI members and others delivered empty paper plates to Rep. Nunn’s office in March – people will starve and children will go hungry under this proposed budget.

What irks me the most is they’re not doing this because our country is poor and can’t afford it. They’re doing it to extend Trump’s tax breaks for millionaires and billionaires. Any meager tax cut for lower income families will be wiped out by the cuts to public services. Or by the cost of gas for rural folks to drive even further to the nearest doctor, hospital, or pharmacy.

Medicaid and SNAP are investments in our long-term health and local communities. Tax cuts for the rich are not. Money and resources continue to be pulled out of rural America and I’m sick of it. And if Iowa’s Representatives and Senators go along with it, shame on them. This budget fiasco will show us who they truly represent.

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Barb Kalbach is a 4th generation family farmer, retired registered nurse, and board member of Iowa Citizens for Community Improvement. Barb can be reached at

barbnealkalbach@gmail.com.