Rebuilding Rural America for Our Future

Rural America deserves a partner in the White House. Here’s my plan to put rural Americans back in the driver’s seat.

A bright future for the nation depends on the health and prosperity of rural America. Americans across every community — cities, suburbs, towns, and rural areas — face the shared challenges of our time: a climate crisis that threatens our way of life; an economy that has left far too many Americans out of the middle class; a corrupt government that puts the interests of corporations and the wealthy before those of our communities and working people.

Like all Americans, rural Americans want a fair shot to earn a good life and contribute to the progress of our nation. But our broken economy and broken government have left talent on the sidelines as rural America has suffered a series of crippling losses for decades.

And too many politicians have turned a blind eye or made empty promises to uplift rural Americans, only to leave them behind and make their lives harder once in office.

The consequences have been devastating for our small towns and rural areas: family farms have folded because of industry consolidation and unstable markets. Local manufacturing plants and the jobs they create have been lost to automation and foreign countries. Big box stores run by distant corporations have hollowed out small businesses that once brought wealth to Main Street.

With these losses, local services, from hospitals and schools to libraries and first responders, have suffered. Expectant mothers are forced to drive hours to deliver their babies or receive urgent care. Local banks have closed, leaving behind entrepreneurs who lack the capital to translate their ideas into new businesses. Families and communities have been hollowed out and faced an emotional toll as young people leave their hometowns in search of opportunity elsewhere.

But, here’s the thing to know about rural Americans: they’re not giving up. And this nation can’t give up on them. Instead we must treat rural America like the national asset it is.

Our rural communities steward the nation’s natural resources that supply our food, energy, and clean water, and that spark our sense of adventure. They reflect the diversity that makes America strong;immigrants are driving rural population growth, people of color make up three-quarters of new rural residents, and rural America continues to serve as home to tribal lands. Our small towns and rural areas are more often home to the Americans who enlist in the military to defend our country. Rural America is full of innovators, problem solvers and doers.

Rural America deserves a partner in the White House and in my administration they will get one.

As president, I will launch a national partnership to rally the public, philanthropic, and private sectors to the task of empowering local leaders to build a rural America that can thrive for the next 100 years and beyond. My administration will put our farmers, workers and small business owners back in the driver’s seat to help grow an economy that benefits everyone. And we will fight to improve access to healthcare for all Americans, regardless of where they live.

Here’s my plan:

A National Partnership for a Prosperous Rural America

My administration will write a new chapter in the relationship between rural America and the federal government that provides the level of attention and support our rural communities deserve as a national asset. While the American economy has undergone a radical transformation, federal policy to support rural communities has not kept pace. The answers to challenges in our small towns and rural areas are already there. Not only the natural assets, but the know-how, ingenuity, and commitment to community. Rural Americans have succeeded and thrived when they have the tools to capture the potential of these assets — whether through investments, partnerships, or strategic technical assistance.

1 As president, I will establish a $50 billion Rural Future Partnership Fund at the USDA to build resilient rural regions from the Heartland, Mountain West, and Coal Country to the Delta, Northern Forest, and Indian Country. Ideas, plans, and energy are plentiful in rural communities. What is lacking is investment and the tools to turn that potential into new economic opportunities. The federal government has failed to adapt to the needs of our communities, proposing one-size-fits-all programs that ignore unique opportunities and challenges. When local leaders have turned to government, they get caught in a web of bureaucratic complexity and inaction.

The Rural Future Partnership Fund would address these federal failures with a $50 billion partnership with the country’s rural regions and tribal nations, providing multi-year, flexible, formula block grants and easier access to billions of dollars in other existing federal assistance. It will empower local leaders to develop and implement comprehensive revitalization strategies, putting the power to create change into the hands of the communities themselves — communities like Storm Lake and Mason City, Iowa, Laconia and Claremont, New Hampshire, Ogdensburg and Batavia, New York and their surrounding rural areas.

Funds could be used for a cross-section of purposes like rebuilding water lines and affordable housing, farm-to-market roads and railroad transportation, disaster recovery, growing regional food systems, and supporting entrepreneurship and job training programs. And to improve the quality of life of all of our rural communities, funding would support local efforts to expand critical services like child care, public education, long-term care, and health care, including mental health and addiction treatment.

Expanding on the Obama Administration’s StrikeForce Initiative, the Rural Innovation and Partnership Administration will deploy cross-agency teams in each state to work with local leaders in cutting through bureaucracy and streamlining programs so it is easier to access investment from across the federal government, especially in persistently poor rural communities. A new Rural Future Corps will also create a pipeline of young people and public servants to work with local leaders to fill gaps in local government, economic development, health care, and education.

2 We will launch a cooperative business initiative, working with communities, business owners, and workers to address gaps in community services and create economic opportunity. Rural America has long been shaped by co-ops, from agriculture and rural utilities to credit unions and Farm Credit institutions. Today, co-ops can continue this legacy of building local wealth and quality of life. Co-ops can enable rural Americans to address a new set of challenges like inadequate child care, homecare, housing, and high-speed internet service. Rural communities could use co-ops to keep local grocery stores open and helping retiring business owners transfer their companies to workers, consumers, and farmers, keeping Main Street businesses alive, preventing job loss, and sharing wealth across rural America.

Building on the bipartisan passage of my Main Street Employee Ownership Act, as president, I would create a White House Council on a Cooperative Economy to ensure all federal loan, contracting, and technical assistance programs are accessible by cooperatives, unlocking billions of dollars in potential federal investment. And so that rural regions fully capture the potential of using cooperatives, we will significantly increase support to cooperative development by fully funding the Rural Cooperative Development Program at $40 million per year.

3 My administration will invest in an entrepreneurial, creative economy to energize a new generation of rural innovators. We are leaving great ideas on the shelf because too many of our rural entrepreneurs are not given a shot by investors. I will change this by expanding on my bipartisan Rural Jobs and Investment Act passed in the Farm Bill to scale the number of Rural Business Investment Companies so more rural entrepreneurs have access to the investment they need. A Rural RISE initiative will also establish a national network of innovation ecosystems and venture development organizations that provide capital, mentorship, and networking so more entrepreneurs can turn an idea into a company.

Nature, arts, and cultural heritage are key ingredients of dynamic places that offer a high quality of life and attract young people. Under my presidency, we will tap the tremendous economic development potential of rural arts, food, and cultural heritage through a new $250 million Partnership for Creative Rural Economies. This program would award states and rural communities funds to help communities identify what makes them unique and promote those assets. Rural regional councils would invest in downtown Main Streets, promote agritourism, cultural, and historic sites, assist art centers and libraries to expand public services like makerspaces. Rural communities could also enhance performance arts and entertainment opportunities, which rural businesses know are critical to attracting and retaining workers.

4 At this time of transformational innovations like artificial intelligence and precision agriculture, I will ensure rural America shares in the opportunity of the digital economy. Rural America is a field of potential if provided a chance to adapt and succeed. We will invest $60 billion to connect all rural Americans to high-speed Internet, including next generation gigabit systems. I will get the job done working with private providers, states, rural electric cooperatives, broadband cooperatives, and community broadband networks. This investment will be directed by detailed, accurate broadband service maps that reflect actual service availability.

Just as the nation’s agricultural extension system has informed farmers of new research and technologies to improve their operations, my administration will create a Digital Extension Service. This will help to advise and assist farmers, rural entrepreneurs, and community leaders in adopting digital technologies for precision agriculture, e-commerce, telemedicine, high-tech manufacturing, and opportunities for attracting remote workers as new residents. The Digital Extension Service would also work with 4-H and Future Farmers of America (FFA) to inspire and mentor young people across rural America in the application of STEM education.

Under my leadership, we will also create a $750 million Rural Tech Skills initiative with President Obama’s TechHire initiative as a model. This program would fund training partnerships between community colleges, community-based and labor organizations, and employers to prepare the rural workforce for tech jobs across industries like clean energy, advanced manufacturing, cybersecurity, and health IT.

Farmers and Rural Communities Will Build the New Green Sustainable Economy

In a new partnership with America’s rural leaders and farmers, my administration will tackle the nation’s challenges as one country united in purpose to halt climate change, protect our food supply, water, forests, and fisheries, and rebuild the middle class.

1 As president, I will put farmers and rural communities in the driver’s seat to lead the nation’s climate action. The impact of climate change can be seen and felt every day, in every community. This is yet another challenge for farmers who have long battled weather, pests, and weeds as they produced food to feed their families, their communities, our nation, and the world. Because farmers have long been stewards of our natural resources, and their work is affected by climate change so directly, farmers are uniquely well positioned to develop and lead a transition to more sustainable production practices and future. Rural communities will be the forefront of our nation’s fight against climate change and farmers and producers will be part of the solution to the greatest challenge of our time.

We must support producers when they take risks to address climate problems, and help them improve the profitability and sustainability of their farms by paying them for the environmental services they provide. Farmers should receive support from USDA to develop new practices that put carbon back into their soils, reduce inputs, and limit nutrient loss. Under my administration, we will give farmers the resources they need to be champions for the climate. We will:

• Develop new insurance protections so farmers who want to innovate have access to an expanded whole farm revenue program to insure against loss as they develop and pilot innovative conservation oriented production systems.
• Improve the Conservation Stewardship Program and Environmental Quality Incentives program funding and options to support farmers who want to implement new, validated practices to stem climate change are eligible to receive payments to implement carbon sequestration on their farm as they do for providing other environmental services.
• Develop support of public sector agricultural scientists at ARS, land grant universities, and extension services for farmers to develop, evaluate, and refine carbon sequestration and advanced nutrient management programs on their farms.
• Launch a Made In Rural America initiative to support bio-based manufacturing as farm and forest products will be at the center of efforts to decarbonize our economy by replacing fossil fuels with renewable bio-based materials and forcing industrial polluters to pay the true cost of their production.
• Develop new energy infrastructure to power farms. The transition to advanced battery technology and renewable energy, including biofueled equipment run on fuels they can produce themselves will help farmers to reduce climate impacts. Building out solar and small wind power in rural communities will allow farmers to produce their own power and connect to microgrids that power their households, farms, and communities.
• Compensate forest owners for sustainable forest management so rural economies that depend on public lands and forests will be compensated not just for the timber they produce but for the environmental services, spaces for recreation, and durable carbon sequestration they provide.

My Climate Plan declares climate action as this generation’s moonshot, which requires the energy, talents, and commitment of every American. That includes our farmers, producers, and rural innovators. The only way we tackle climate change is when our farmers and rural communities are leading the charge and we are paying them for their solutions. We have the tools to get this done now and help them win this fight.

2 I will prioritize the interests of our farmers ahead of agribusinesses. In addition to new systems of support for our farming families to fight climate change, we must also maintain and expand access to markets at home and abroad for producers of all sizes. That means helping farmers, producers, and fishermen better serve regional markets and minimize volatility caused by export centered production. That means not picking trade fights with no strategy and instead building global alliances to forge fair trade deals that benefit our farmers and workers because the prosperity of both is interdependent.

We must make the Farmers Bill of Rights a reality. Corporate influence and money have corrupted our nation’s farm and food policies for too long, threatening our economic and national security by making our food supply reliant upon a few agribusiness companies, some of which are foreign-owned, and making it too difficult for family farmers to achieve success. Farmers need access to fair capital, a diversity of seed and inputs, and equipment that they can repair and maintain without a corporate gatekeeper. Farm data should belong to the farmer and be portable, secure, shareable with trusted service providers, and not monetized by large corporations to sold back to farmers or financial institutions.

By renewing the opportunity for all to succeed in the farming economy, we can attract and retain more young people who will grow their own sustainable and profitable operations. Their hard work and commitment to their communities will reinvigorate rural places and civic institutions.

Protecting the Health of Rural America

Rural Americans must be able to access affordable, quality care regardless of where they live. We must address our rural health crisis immediately and ensure we are improving access to care and lowering costs by investing in community-based solutions. We must invest in rural health infrastructure with bold, innovative approaches that serve patients well beyond the traditional, yet still essential, hospital and clinic delivery system. My approach to health care doesn’t just consider rural communities, it gives rural communities the resources and autonomy they need to find solutions.

1 I will invest in rural health infrastructure like hospitals and clinics, but we have to build capacity with innovative delivery systems that best meet the needs of rural communities — like basic transportation, telehealth, and remote patient monitoring that are necessary to respond proportionately to the largest rural health challenges, including the mental health and addiction crisis. Total healthcare costs are reduced when appropriate rural health services are coordinated in a universal healthcare system.

We will prioritize responsible reimbursement for coordination activities, community case management, transportation, and other supports that ensure access to general healthcare and wellness services. My plan will use a comprehensive approach to substance abuse treatments that supports trauma-informed care, funding for peer support, prevention opportunities, and increased access to behavioral health professionals.

I will also empower healthcare professionals, such as nurse practitioners and physician assistants in rural health clinics to practice to the top of their license in areas like telehealth and mental health services. Rural health clinics would be designated as distant site providers for telehealth services under Medicare and we should expand this important healthcare tool.

Strong networks of support for aging in place are critical for rural communities — it’s time to make comprehensive and affordable long term services and supports (LTSS) a reality. My administration will develop and implement quality measures specific to rural communities, including measures specific to self-directed services and community integration

My health plan would incentivize Managed LTSS plans to include a ‘Rebalancing and Community Incentive Plan’ to outline how they would expand Home and Community-Based Services and promote community integration, particularly for rural communities.

2 Each rural community is unique, and only the people who live in them know best how to fix the problems. My administration will empower rural America to implement community-based approaches to health and wellness, and put control back in the individual’s hands, not with insurance companies and healthcare corporations.

We must consider alternative models of healthcare delivery that promote a more diverse, interdisciplinary combination of providers. My administration will reform rural healthcare workforce policies to include more flexibility for health professionals at rural health clinics and make the services they provide eligible for adequate reimbursement.

We will improve compensation and benefits and ensure high quality training and continuing education for home health aides who are critical in working with family and friends to support people with disabilities, the aging, and other health-impacted individuals.

I will invest significantly in community-based grant programs, such as the Rural Health Outreach Grant Program, that fund community-based projects that increase access to care that would not otherwise have been available.

Rural communities also deal with racial and ethnic health disparities, in some cases with wider disparities than in other populations. The nation’s healthcare system must include cultural sensitivity to best serve rural patients. And new investments must be made to expand access to health care facilities and professionals in Native communities to address the significant gap in services faced by Indigenous people.

We must also recognize that access to healthcare requires the appropriate infrastructure to administer and receive it. My plan will invest in and support transportation development to get rural America up to speed with the fast-changing healthcare world. We have to invest in research and development for patients and health systems that include telemedicine, ride sharing, drone delivery, or adapting technology to improve accessibility like allowing older motorists to drive safely for longer.

3 I will modernize Medicare and Medicaid reimbursement structures for rural hospitals and health clinics because they are falling far below the real cost of delivering care.

We need financial assurances for rural health providers that they will be able to keep up in a future of redesigned healthcare payments and delivery systems focused on quality and value for payment. Rural communities, their challenges, and their financial circumstances should be thoughtfully accounted for and supported under new payment models. We should empower rural health clinics to fully provide and be reimbursed for more routine services, like clinical laboratory services.

My promise to rural America:

In my travels to rural Iowa, New Hampshire, or upstate New York, I’ve heard the same thing: it’s time for politicians to listen and learn. During my rural listening tour in Iowa, I met with caucus-goers in Atlantic to talk about education and job training opportunities, and with health care providers in Clarinda worried about mental health issues and access to care.

As president, I will always listen to the needs of rural America. I’m proud to have been born and raised in upstate New York and to be the first U.S senator from New York to serve on the Agriculture Committee in over forty years. I’ve been a champion for family farms and dairy farmers in my state, and I’ve fought for more investment in rural broadband, entrepreneurs, and job training in the Farm Bill.

In my campaign, I have championed a Family Bill of Rights that would improve access to OB-GYN services for pregnant women in rural areas, so they don’t have to drive hours for care. I have also championed a new climate change moonshot plan that would empower rural leaders to embrace clean energy as a way to cut costs, create jobs, and steward our natural resources.

America deserves a president who fights for every inch of this country and our shared prosperity, and makes good on their promises. I believe our nation is strongest when we work together in common cause to tackle the nation’s challenges and push forward in achieving a more perfect union for all Americans.

As president, I will always value the contributions of rural America, and invest in the grit, ingenuity and talent of rural communities to rebuild a partnership for our shared future.