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Trump administration announces allocation of rural health fund to states

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Trump administration announces allocation of rural health fund to states

States will share $10 billion for rural health care next year in a program that aims to offset the Trump administration’s massive budget cuts to rural hospitalsfederal officials announced Monday.

But while every state applied for money from the Rural Health Transformation Program, it won’t be distributed equally. And critics worry that the funding might be pulled back if a state’s policies don’t match up with the administration’s.

Officials said the average award for 2026 is $200 million, and the fund puts a total of $50 billion into rural health programs over five years. States propose how to spend their awards, and the Centers for Medicare and Medicaid Services assigns project officers to support each state, said agency administrator Dr. Mehmet Oz.

“This fund was crafted as part of the One Big Beautiful Bill, signed only six months ago now into law, in order to push states to be creative,” Oz said in a call with reporters Monday.

Under the program, half of the money is equally distributed to each state. The other half is allocated based on a formula developed by CMS that considered rural population size, the financial health of a state’s medical facilities and health outcomes for a state’s population.

The formula also ties $12 billion of the five-year funding to whether states are implementing health policies prioritized by the Trump administration’s “Make America Healthy Again” initiative. Examples include requiring nutrition education for health care providers, having schools participate in the Presidential Fitness Test or banning the use of SNAP benefits for so-called junk foodsOz said.

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.

Experts say fund is inadequate in face of other cuts

Oz and other federal officials have touted the program as a 50% increase in Medicaid investments in rural health care. Rep. Don Bacon, a Republican from Nebraska who has been critical of many of the administration’s policies but voted for the budget bill that slashed Medicaid, pointed to the fund when recently questioned about how the cuts would hurt rural hospitals.

“That’s why we added a $50 billion rural hospital fund, to help any hospital that’s struggling,” Bacon said. “This money is meant to keep hospitals afloat.”

But experts say it won’t nearly offset the losses that struggling rural hospitals will face from the federal spending law’s $1.2 trillion cut from the federal budget over the next decade, primarily from Medicaid. Millions of people are also expected to lose Medicaid benefits.

Estimates suggest rural hospitals could lose around $137 billion over the next decade because of the budget measure. As many as 300 rural hospitals were at risk for closure because of the GOP’s spending package, according to an analysis by The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

“When you put that up against the $50 billion for the Rural Health Transformation Fund, you know — that math does not add up,” Cochran-McClain said.

She also said there’s no guarantee that the funding will go to rural hospitals in need. For example, she noted, one state’s application included a proposal for healthier, locally sourced school lunch options in rural areas.

And even though innovation is a goal of the program, Cochran-McClain said it’s tough for rural hospitals to innovate when they were struggling to break even before Congress’ Medicaid cuts.

“We talk to rural providers every day that say, ‘I would really love to do x, y, z, but I’m concerned about, you know, meeting payroll at the end of the month,’” she said. “So when you’re in that kind of crisis mode, it is, I would argue, almost impossible to do true innovation.”

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The Associated Press Health and Science Department receives support from the Howard Hughes Medical Institute’s Department of Science Education and the Robert Wood Johnson Foundation. The AP is solely responsible for all content.

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The Dictatorship

Driver shot in Minneapolis is at least the fifth person killed in US immigration crackdown

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Driver shot in Minneapolis is at least the fifth person killed in US immigration crackdown

The fatal shooting Wednesday of a woman by an immigration officer in Minneapolis was at least the fifth death to result from the aggressive U.S. immigration crackdown the Trump administration launched last year.

The Department of Homeland Security said the officer fired in self-defense as 37-year-old Renee Nicole Macklin Goodtried to run down officers with her vehicle. Minneapolis Mayor Jacob Frey said video of the incident showed it was reckless and unnecessary. It occurred as the federal agency escalates immigration enforcement operations in Minnesota by deploying an anticipated 2,000 agents and officers.

Last September, Immigration and Customs Enforcement fatally shot another person outside Chicago. Two people have died after being struck by vehicles while fleeing immigration authorities. And a California farmworker fell from a greenhouse and broke his neck during an ICE raid last July.

No officers or agents have been charged in the deaths.

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Cook from Mexico shot during a traffic stop

ICE agents fatally shot Silverio Villegas González during a traffic stop Sept. 12 in suburban Chicago. Relatives said the 38-year-old line cook from Mexico had dropped off one of his children at day care that morning.

At the time, the Department of Homeland Security said federal agents were pursuing a man with a history of reckless driving who entered the country illegally. They alleged Villegas González evaded arrest and dragged an officer with his vehicle.

Homeland Security said the officer opened fire fearing for his life and was hospitalized for “serious injuries.” However, local police body camera videos showed the agent who shot Villegas González walking around afterward and dismissing his own injuries as “nothing major.”

Homeland Security has said the death remains under investigation.

Another shooting, this one non-fatal, occurred in Chicago last fall. Marimar Martinez survived being shot five times by a Border Patrol agent but was charged with a felony after Homeland Security officials accused her of trying to ram agents with her vehicle. The case was dismissed after videos emerged that Martinez’s attorneys said showed an agent steering his vehicle into Martinez’s truck.

Farmworker fell from greenhouse roof during ICE raid

Immigration authorities were rounding up dozens of farmworkers July 10 at Glass House Farms in southern California when Jaime Alanis fell from the roof of a greenhouse and broke his neck. The 57-year-old laborer from Mexico died at a hospital two days later.

Relatives said Alanis had spent a decade working at the farm, a licensed cannabis grower that also produces tomatoes and cucumbers, located in Camarillo about an hour east of Los Angeles. They said he would send his earnings to his wife and daughter in Mexico.

During the raid, Alanis called family to say he was hiding. Officials said he fell about 30 feet (9 meters) from the greenhouse roof.

The Department of Homeland Security said Alanis was never in custody and was not being chased by immigration authorities when he climbed onto the greenhouse.

Man struck on California freeway after running from Home Depot

A man running away from immigration authorities outside a Home Depot store in southern California died after being hit by an SUV while he tried to cross a nearby freeway on Aug. 14.

Police in Monrovia northeast of Los Angeles said ICE agents were conducting enforcement operations when the man fled on foot to Interstate 210. He was running across the freeway’s eastbound lanes when an SUV hit him while traveling 50 or 60 mph miles (80 or 97 kph). He died at a hospital.

The man killed was later identified by the National Day Laborer Organizing Network as 52-year-old Roberto Carlos Montoya Valdez of Guatemala.

The Department of Homeland Security said Montoya Valdez wasn’t being pursued by immigration authorities when he ran.

Gardener from Honduras killed on Virginia interstate

A pickup truck fatally struck Josue Castro Rivera on a highway in Norfolk, Virginia, as he tried to escape immigration authorities during a traffic stop Oct. 23.

Castro Rivera, 24, of Honduras, was heading to a gardening job with three passengers when ICE officers pulled over his vehicle, according to his brother, Henry Castro.

State and federal authorities said Castro Rivera ran away on foot and was hit by a pickup truck on Interstate 264.

The Department of Homeland Security said Castro Rivera’s vehicle was stopped as part of a “targeted, intelligence-based” operation and that Castro Rivera had “resisted heavily and fled.”

His brother said Castro Rivera came to the U.S. four years earlier and worked to send money to family in Honduras.

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AP journalists Sophia Tareen in Chicago and Michael Biesecker in Washington contributed. Bynum reported from Savannah, Georgia.

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ICE STORM: AGENT KILLS AMERICAN

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ICE STORM: AGENT KILLS AMERICAN

MINNEAPOLIS (AP) — An Immigration and Customs Enforcement officer shot and killed a Minneapolis driver on Wednesday during the Trump administration’s latest immigration crackdown on a major American city — a shooting that federal officials said was an act of self-defense but that the mayor described as reckless and unnecessary.

The 37-year-old woman was shot in the head in front of a family member in a snowy residential neighborhood south of downtown Minneapolis, just a few blocks from some of the oldest immigrant markets and about a mile (1.6 kilometers) from where George Floyd was killed by police in 2020.

Her killing after 9:30 a.m. was recorded on video by witnesses, and the shooting quickly drew a large crowd of angry protesters. By evening, hundreds were there for a vigil to mourn her death and urge the public to resist immigration enforcers.

Crowds gathered in Minneapolis on Wednesday as they protested and held a vigil for a woman killed during the Trump administration’s latest immigration crackdown. (AP video shot by: Mike Householder)

The woman, Renee Nicole Macklin Good, had a 6-year old child, her mother told the Minnesota Star Tribune. Macklin Good described herself on social media as a “poet and writer and wife and mom” who was from Colorado.

Videos taken by bystanders with different vantage points and posted to social media show an officer approaching an SUV stopped across the middle of the road, demanding the driver open the door and grabbing the handle. The Honda Pilot begins to pull forward and a different ICE officer standing in front of the vehicle pulls his weapon and immediately fires at least two shots into the vehicle at close range, jumping back as the vehicle moves toward him.

It is not clear in the videos if the vehicle makes contact with the officer and there is no indication of whether or not the woman had interactions with ICE officers before the videos started. After the shooting, the SUV speeds into two cars parked on a curb nearby before crashing to a stop.

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In another video taken at the scene, a woman, who described Macklin Good as her spouse, is seen crying near the vehicle. The woman, who was not identified, said the couple had only recently arrived in Minnesota and that they had a child.

“Our officer followed his training, did exactly what he’s been taught to do in that situation,” Homeland Security Secretary Kristi Noem said at a news conference in Minneapolis Wednesday evening.

Homeland Security Secretary Kristi Noem described the incident as an “act of domestic terrorism” carried out against ICE officers by a woman who “attempted to run them over and rammed them with her vehicle. An officer of ours acted quickly and defensively, shot, to protect himself and the people around him.”

In a social media post, President Donald Trump made similar accusations against the woman and defended ICE’s work.

Local officials dispute the narrative

Noem claimed the woman was part of a “mob of agitators” and said the officer followed his training. She said the veteran officer who fired his gun had been rammed and dragged by an anti-ICE motorist in June.

“Any loss of life is a tragedy, and I think all of us can agree that in this situation, it was preventable,” Noem said, adding that the FBI would investigate.

But Minneapolis Mayor Jacob Frey blasted Noem’s version of what happened as “garbage” and criticized the federal deployment of more than 2,000 officers to the Twin Cities of Minneapolis and St. Paul as part of the immigration crackdown.

“What they are doing is not to provide safety in America. What they are doing is causing chaos and distrust,” Frey said, calling on the immigration agents to leave. “They’re ripping families apart. They’re sowing chaos on our streets, and in this case, quite literally killing people.”

“They are already trying to spin this as an action of self-defense. Having seen the video myself, I wanna tell everybody directly, that is bullshit,” the mayor said.

AP AUDIO: Minneapolis mayor says ICE officer’s killing of a motorist was ‘reckless’ and wasn’t self-defense

AP’s Lisa Dwyer reports on a fatal shooting in Minneapolis by federal agents.

Shooting is fifth linked to crackdowns

The shooting marked a dramatic escalation of the latest in a series of immigration enforcement operations in major cities under the Trump administration. The death of the woman in Minneapolis was at least the fifth linked to immigration crackdowns.

The Twin Cities have been on edge since DHS announced Tuesday that it had launched the operation, which is at least partly tied to allegations of fraud involving Somali residents. Name said they had already made “hundreds and hundreds” of arrests.

A large throng of protesters gathered at the scene after the shooting, where they vented their anger at the local and federal officers who were there, including Gregory Bovinoa senior U.S. Customs and Border Patrol official who has been the face of crackdowns in Los Angeles, Chicago and elsewhere.

“She was driving away and they killed her,” said Lynette Reini-Grandell, a local resident who was among those who filmed the shooting.

In a scene that hearkened back to the Los Angeles and Chicago crackdowns, bystanders heckled the officers, chanting “ICE out of Minnesota” and blew whistles that have become ubiquitous during the operations.

Governor calls for calm

Minnesota Gov. Tim Walz said he’s prepared to deploy the National Guard if necessary. He described the killing as “predictable” and “avoidable.” He also said like many, he was outraged by the shooting, but he called on people to keep protests peaceful.

“They want a show. We can’t give it to them. We cannot,” the governor said.

Minneapolis Public Schools canceled school, sports and activities for Thursday and Friday, saying in a statement that the decision was “due to safety concerns related to today’s incidents around the city.”

Minneapolis Police Chief Brian O’Hara briefly described the shooting to reporters but, unlike federal officials, gave no indication that the driver was trying to harm anyone.

There were calls on social media to prosecute the officer who shot the driver. Commissioner Bob Jacobson of the Minnesota Department of Public Safety said state authorities would investigate the shooting with federal authorities.

“Keep in mind that this is an investigation that is also in its infancy. So any speculation about what has happened would be just that,” Jacobson told reporters.

The shooting happened in the district of Democratic Rep. Ilhan Omar, who called it “state violence,” not law enforcement.

For nearly a year, migrant rights advocates and neighborhood activists across the Twin Cities have been preparing to mobilize in the event of an immigration enforcement surge. From houses of worship to mobile home parks, they have set up very active online networks, scanned license plates for possible federal vehicles and bought whistles and other noisemaking devices to alert neighborhoods of any enforcement presence.

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Dell’Orto reported from St. Paul, Minnesota. Associated Press reporters Steve Karnowski in Minneapolis, Ed White in Detroit, Valerie Gonzalez in Brownsville, Texas, Mark Vancleave in Las Vegas, Michael Biesecker In Washington and Jim Mustian in New York contributed.

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What RFK Jr. and the USDA’s new food pyramid get wrong

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ByBrian Kateman

The Trump administration unveiled dietary guidelines this week that flip the food pyramid Americans have known for decades, encouraging greater consumption of protein, particularly meat and dairy.

That’s not exactly what the average American, who already eats 227 pounds of meat a year, needs to hear. The recommendations, the latest work of the Make America Healthy Again movement of Health and Human Services Secretary Robert F. Kennedy Jr., actually puts health at greater risk.

The new nutrition recommendations actually put health at greater risk.

For one thing, protein is among the few nutrients in which most Americans are not deficient. Health experts widely agree that most of us eat much more protein than necessary. The new pyramid illustration includes a big hunk of steak and a package of ground beef at the top; never mind, apparently, that the American Cancer Society considers red meat to be “probably carcinogenic to humans.” The American Heart Association has long advised people to limit consumption of red meat because of its deleterious health effects, including as a contributor to heart disease.

In an event Thursday with Agriculture Secretary Brooke Rollins promoting the revised nutrition policy, Kennedy referred to the heart association as a “big villain.” In Kennedy’s telling, the organization “continues to accept millions of dollars from the biggest processed food makers in this country.” Doing so, he argued, “fortified a dogma that vilified and demonized good food.”

The new nutrition guidelines also recommend full-fat dairy, directly contradicting the heart association’s recommendation of reduced-fat options, such as fortified plant-based milk alternatives.

Cancer, heart disease and diabetes are among the leading causes of death and drivers of health care costs in the United States, according to a different federal agency, the Centers for Disease Control and Prevention. The USDA nutrition guidelines say they target those same chronic illnesses but promote the high-fat, high-cholesterol foods that study after study shows contribute to them.

Ultimately, this isn’t just bad advice; it’s also dangerous to public health and the planet.

The slogan of the guidelines is “Eat Real Food,” which is defined as “whole, nutrient-dense, and naturally occurring.” Putting aside that animal products — most of which come from factory farms — are arguably the most processed foods on Earth, the only thing about these guidelines that’s significantly different from past pyramids is the emphasis on meat and dairy. This happens to be the opposite of the advice of virtually every credible health-related organization.

Beef cattle.
Beef cattle in corrals at a ranch on Nov. 11, 2025, in Sonoita, Arizona. Rebecca Noble / Bloomberg via Getty Images

The Department of Agriculture may put out nutritional guidelines, but it’s worth remembering that it isn’t a medical body — it represents farm operations, including cattle ranchers and dairy farmers. As Kennedy said on Thursday, “It’s important that the American people know that sometimes they are getting medical advice from people who have an economic stake in that advice, and we have a responsibility to question that.”

Indeed. The USDA has been accused of having a revolving door for lobbyists and of promoting the interests of industry over public health. In October, Rollins announced a battery of plans to “strengthen the American beef industry, reinforcing and prioritizing the American rancher’s critical role in the national security of the United States.” What beef has to do with national security, I can’t say, but Americans’ health clearly isn’t the only priority of the Trump administration.

To be fair, dietary guidelines have often been shaped by corporate interests.

To be fair, dietary guidelines have often been shaped by corporate interests. In the mid-20th century, global attention to a “protein gap” in developing countries led the United Nations to establish a Protein Advisory Groupwhich promoted Western nutritional ideas and helped create markets for surplus food exports. By the 1970s, experts recognized that the real problem was not protein deficiency but a lack of sufficient calories. Companies such as Nestlé profited from these international nutrition programs, raising questions about the influence of industry on dietary advice.

Now the U.S. government is effectively pushing another protein panic. A lot of nutritional science is more up in the air than many might think, but this is an area where medical authorities have some consensus. There’s just no basis for the claim that Americans need more protein, and certainly not from animal sources. It’s not just the American Heart Association pointing in the exact opposite direction.

There’s just no basis for the claim that Americans need more protein, and certainly not from animal sources.

And decades’ worth of scientific evidence shows the deleterious effects of industrial animal agriculture on the health of the planet. It’s a major contributor to climate change, putting people around the world at greater risk of extreme weather events, respiratory illnesses, heat-related illnesses, insufficient access to clean water and exposure to water-borne disease. In a sad irony, climate change threatens our food systems and limits the amount of decent food humans are able to produce. Agricultural practices in the meat industry have made it a vector for disease and have led to mass outbreaks of illness.

Dietary guidelines shape school luncheshospital meals, public assistance programs and more, including the advice given to millions of people who do not have the luxury of opting out. When federal guidance elevates red meat and full-fat dairy — foods long associated with higher rates of cancer, heart disease, diabetes and environmental harm — the costs are shouldered by poorer families, many already struggling with chronic illness, and by communities facing a warming planet.

This isn’t just a technical disagreement about nutrition; it’s a choice about whose interests public policy serves. And in this case, the answer is not the health of the American public but the balance sheets of meat and dairy companies. Such is the price of Making Agribusinesses Happy Again.

Brian Kateman

Brian Kateman is a co-founder and the president of the Reducetarian Foundation, a nonprofit organization dedicated to reducing consumption of meat, eggs and dairy to create a healthy, sustainable and compassionate world. He is the author of “Meat Me Halfway” — inspired by a documentary of the same name — and the editor of “The Reducetarian Cookbook” and “The Reducetarian Solution.” He is an adjunct professor of environmental science and sustainability at Kean University and teaches environmental communications at Fordham University.

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