A movement that helped Donald Trump connect with health-conscious voters is facing a complicated reality in rural America, where a new survey finds many supporters have yet to see improvements in their own communities.
About half of rural registered voters identify with the Make America Healthy Again movement championed by Health and Human Services Secretary Robert F. Kennedy Jr., according to a new Associated Press-KFF survey.
But enthusiasm for MAHA does not necessarily translate into satisfaction with the Trump administration’s health care record.
Roughly 8 in 10 rural voters surveyed said the administration’s health policies have either negatively affected health in their communities or made no noticeable difference. Even among voters who support MAHA, 68 percent gave one of those two responses.
The findings are notable because rural voters remain an important part of Trump’s political coalition. Nearly seven in 10 rural voters backed Trump in the 2024 presidential election, according to KFF’s analysis.
Still, the survey does not show rural voters simply abandoning Trump or the Republican Party. Instead, it paints a more complicated picture in which voters may support MAHA’s goals while questioning whether federal policy has produced meaningful changes where they live.
Health care costs appear to be a particularly serious concern.
About two-thirds of rural voters said they were very or somewhat worried about being able to afford health care for themselves or their families. Nearly half said their communities do not have enough doctors or other health care providers, while even more reported shortages of mental health professionals.
The percentage saying their communities lack enough hospitals has also increased significantly compared with a similar KFF-Washington Post survey conducted in 2017. Thirty-five percent now report an inadequate number of hospitals, up from 21 percent in the earlier survey.
Those pressures could make health care an increasingly visible issue as voters prepare for the 2026 midterm elections.
The concerns are especially pronounced among rural residents who rely on Medicaid. The AP-KFF survey found that 80 percent of working-age rural Medicaid recipients were worried about health care costs.
Congressional Republicans and Trump last year enacted a sweeping tax and spending package that included major changes to Medicaid. KFF says the law reduces projected federal Medicaid spending by more than $900 billion over a decade and establishes new eligibility requirements.
The Trump administration has simultaneously launched a major program specifically designed to bolster rural medicine.
The Rural Health Transformation Program provides $50 billion over five years, with $10 billion available annually from fiscal years 2026 through 2030. All 50 states received first-year awards, ranging from roughly $147 million to $281 million. Federal officials say the money is intended to expand rural access, strengthen the health care workforce, modernize facilities and improve treatment of chronic disease.
That creates an important distinction in the debate: the survey measures voters’ perceptions of the administration’s policies so far, while some of the administration’s largest rural-health investments are only beginning to be implemented.
The White House has pointed to that funding as evidence that Trump is making rural health care a priority.
White House spokeswoman Allison Schuster told the Daily Beast that the administration had enacted what it calls the largest-ever federal investment specifically aimed at transforming rural health care and argued that its efforts on prescription-drug pricing are also reducing costs.
CMS similarly describes the $50 billion program as an effort to expand access to care, strengthen rural workforces and modernize health infrastructure.
But interviews with rural voters show why the administration still faces skepticism.
Mike Jager, a 58-year-old Iowa pastor and registered Republican who identifies with MAHA, told the AP that the administration’s health policies have had only a “minimal” effect on his community.
He nevertheless remains supportive of Kennedy’s broader health agenda and believes the movement is beginning to push the country in a better direction.
“It’s a beginning,” Jager told the AP, comparing the effort to changing the direction of a very large ship.
Jager lives in Sumner, Iowa, near agricultural land, and said he has watched relatives and neighbors suffer from serious illnesses. Like many MAHA supporters, he is concerned about processed foods, agricultural chemicals and other environmental factors that he believes may contribute to poor health.
Those concerns have become particularly prominent in Iowa amid debate over the state’s cancer rates.
Donna Klocke, a 71-year-old Democrat who lives on a farm in Carroll County and lost her husband to cancer, said serious illness has become painfully familiar in her area.
“It’s just very prevalent,” Klocke told the AP, pointing to farming communities’ exposure to pesticides and other chemicals.
Klocke said she supports the general idea of improving Americans’ health but does not consider herself part of the MAHA movement.
The survey also illustrates the unusual political coalition surrounding Kennedy’s movement.
Many MAHA supporters are Republicans and Trump voters, but the movement’s emphasis on food additives, chronic disease, agriculture and pharmaceutical companies has attracted people whose views do not always fit neatly into traditional party politics.
David Peterson, a political science professor at Iowa State University, said that can create tension when voters agree with Kennedy’s health message but blame other administration policies for making everyday necessities more expensive.
For some families, Peterson said, the desire to purchase healthier food collides with concerns about what they can afford.
At the same time, the polling remains heavily divided by party.
Democratic and independent rural voters were considerably more likely to say Trump administration health policies had harmed their costs or access to care. Republican voters were more likely to say the policies had produced little or no change rather than a negative effect.
Trust in Trump and Kennedy also splits sharply along partisan lines.
About 74 percent of rural Republican voters said they had a great deal or fair amount of trust in Kennedy for reliable health information, compared with roughly 10 percent of rural Democrats. For Trump, the numbers were 69 percent among Republicans and about 5 percent among Democrats.
That suggests the survey is less a straightforward revolt against Trump than a warning about expectations.
Many rural voters remain receptive to MAHA’s promise of reducing chronic disease and changing America’s approach to food and health. What they appear less convinced of is whether those promises have translated into noticeable improvements in medical access, affordability and community health.
The AP-KFF survey questioned 2,241 registered voters living in rural areas nationwide between Aug. 12 and Aug. 24, 2026. The survey used the probability-based SSRS Opinion Panel and has a margin of sampling error of plus or minus 3 percentage points for the full sample.
With the midterms approaching, that gap between support for MAHA’s goals and satisfaction with the results could make rural health care an important issue to watch — particularly as the administration’s new federal rural-health funding begins reaching communities across the country.
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