Rural Health News is a weekly segment of Rural Health Today, a podcast by Hillsdale Hospital.
Welcome back to Rural Health News, the segment of Rural Health Today where we fill you in on the latest in rural health headlines. We’ll cover three headlines in today’s episode: what’s most urgent, a rural health damage report, and a success story to send us into the week.
Most Urgent
Pennsylvania reported two more measles-related deaths—one eighteen-year-old and one forty-year-old, both unvaccinated. These add to the count of four total deaths this year, all in Pennsylvania. The 2025 spike in measles cases has already been overshadowed by the 2026 cases, which continue to climb disproportionately in Pennsylvania. The state’s health department has officially requested emergency support from the CDC as cases continue to surge.
Damage Report
43 states are preparing to implement the new ACA Medicaid Expansion work requirements under H.R. 1, and the race to be ready is causing panic for healthcare providers and enrollees across the country. State health departments are rushing to update operations and policies, and some are trying to integrate tracking technology into their programs to make reporting easier and ensure enrollees don’t unnecessarily lose coverage. The good news is, some states are doing everything possible to communicate with patients and hospitals about their plan for work requirements. Unfortunately, not every state is taking an equally transparent approach, and many Medicaid Expansion enrollees are unsure how their coverage will be affected.
According to the Congressional Budget Office, H.R. 1 will reduce federal spending on Medicaid by $811 billion over ten years. Medicaid work requirements represent one-third of those cuts. The CBO also estimates the requirements will lead to 5.3 million uninsured people by 2034, and another 5 million are expected to lose coverage due to other policies. Most of these coverage losses represent enrollees who are meeting the work requirements, unable to meet the requirements, or face barriers to exemption eligibility like physical health conditions or childcare shortages.
Starting next week, states are required by the federal government to begin their outreach about new work requirements, which go into effect January 1, 2027. As hospitals and healthcare organizations, we will need ensure our patients are being reached by these communications and have the support they need to stay enrolled.
Success Story
Rural older adults often struggle with limited access to transportation and social isolation, making access to preventative and emergency healthcare more challenging. The National Rural Health Association has trained over 200 rural community health workers through a program called the National Rural Age-Friendly Initiative. By partnering with a growing list of academic and community organizations, the NRHA can equip community health workers, community advocates and volunteers with the tools and training they need to support healthy aging in their small-town communities. Participant evaluations have demonstrated an increased understanding of age-friendly care concepts, allowing them to serve their communities better and improve the quality of life for rural older adults.
News sources for this episode:
KFF Health News, “Tracking Implementation of the 2025 Reconciliation Law: Medicaid Work Requirements, August 3, 2026, https://www.kff.org/medicaid/medicaid-work-requirements-tracker-overview/.
Our World Data, “Measles cases in the United States1919 to 2026,” September 18, 2026, https://ourworldindata.org/grapher/number-of-measles-cases?time=1919..2026.
Kristin Wright, “Pennsylvania says an unvaccinated woman has died from measles-related complications,” September 13, 2026, https://www.npr.org/2026/09/13/nx-s1-5968093/pennsylvania-says-an-unvaccinated-woman-has-died-from-measles-related-complications, National Public Radio.
Aria Bendix & Erika Edwards, “Pennsylvania teen dies from measles complications, health officials report,” September 15, 2026, https://www.nbcnews.com/health/health-news/pennsylvania-teen-dies-measles-complications-coroner-cdc-2026-rcna597980, NBC News.
Yasmeen Abutaleb & Dan Levine, “Pennsylvania asks for CDC measles help amid Kennedy dispute,” September 17, 2026, https://www.reuters.com/world/pennsylvania-asks-cdc-help-measles-outbreak-demands-agency-recognize-measles-2026-09-17/, Reuters.
Rebecca Yeboah, “Building Rural Age-Friendly Communities by Expanding CHW Training,” September 1, 2026, https://www.ruralhealth.us/blogs/2026/09-september/building-rural-age-friendly-communities-by-expanding-chw-training, National Rural Health Association.
Rural Health Today is a production of Hillsdale Hospital in Hillsdale, Michigan and a member of the Health Podcast Network. Our host is JJ Hodshire, our producer is Kyrsten Newlon, and our audio engineer is Kenji Ulmer. Special thanks to our special guests for sharing their expertise on the show, and also to the Hillsdale Hospital marketing team. If you want to submit a question for us to answer on the podcast or learn more about Rural Health Today, visit ruralhealthtoday.com.
