In Illinois, more than one in five rural women of childbearing age rely on Medicaid for health coverage, according to the Georgetown University Center for Children and Families and coverage could be in jeopardy as the program faces massive budget cuts in Congress.

Medicaid pays for half of all births across the state.

Kathy Waligora, deputy director of external affairs for the advocacy group Everthrive Illinois, said rural communities already face health care challenges, including hospitals closing or no longer offering maternity care. She emphasized any threats to the program would leave millions without health insurance and affect health outcomes for women and babies across the state.

"We are currently in a fight, an existential fight, for the future of Medicaid," Waligora asserted. "The level of cuts that have been proposed by Republicans in Congress are so severe that every community that uses Medicaid will be threatened."

Waligora pointed out efforts such as the Medicaid expansion in Illinois have decreased maternal mortality by ensuring women are healthier prior to pregnancy.

The report showed severe cuts would result in declining Medicaid revenues and increase uncompensated care costs for rural hospitals. Waligora noted states such as Illinois have used Medicaid state-directed payments to increase reimbursement to rural health centers and hospitals to help them stay open. Currently, eight rural hospitals in Illinois are at risk of immediate closure.

"They are eliminating the ability for states to use those state-directed payments to support rural communities," Waligora underscored. "When we should be investing in a program that supports our communities, instead, we're cutting it to pay for tax cuts for the wealthy and corporations, which is just particularly reprehensible."

Joan Alker, executive director of the Georgetown University Center for Children and Families, said losing rural hospitals affects all women, not just those on Medicaid.

"It doesn't matter who their health insurer is. If they have private insurance, employer insurance, but there's no facility, then they can't safely give birth," Alker pointed out. "That's why these issues are so consequential."

Nationwide, nearly two-thirds of counties lacking a birthing facility or obstetrician are located in rural areas. More than 34% of counties in Illinois are defined as maternity care deserts.

By Ilana Newman for The Daily Yonder.
Broadcast version by Eric Galatas for Colorado News Connection for the Public News Service/Daily Yonder Collaboration

In southwest Colorado, a rural electric cooperative is taking a big step towards energy independence and locally driven power decisions.

La Plata Electric Association (LPEA), a rural electric co-op for parts of Southwest Colorado, is in the middle of a two-year contract termination process to leave Tri-State, the generation and transmission organization that currently provides LPEA with electricity.

Rural electric cooperatives are member-owned, not-for-profit organizations that provide electricity to more than half of the country, including most of rural America. Established in the 1930s, electric co-ops were the government-backed response to a lack of investor-owned electric utilities in rural areas.

Venturing Out on Their Own

The cooperative model means that all customers of the electric co-op are also its owners. Each co-op has a member-elected board of directors that makes strategic decisions, most of which can be made without member approval, based on the bylaws of the individual co-op.

In March 2024, LPEA provided unconditional notice to leave Tri-State, starting a two-year stopwatch for the withdrawal from its contract and membership with the not-for-profit generation and transmission organization.

Leaving Tri-State "will allow us to invest locally and it will allow us to invest in a way that helps bolster economic growth in our service territory," said Chris Hansen, CEO of LPEA in a Daily Yonder interview.

Despite the member-elected board having control over decisions like leaving Tri-State, some members feel misrepresented by their board and do not support the move away from the Tri-State contract.

Dale Ruggles, a member of LPEA, expressed concerns that the LPEA board of directors is making decisions that do not reflect the feelings of their constituents. When asked what he would have wanted to see done differently, Ruggles said he wanted "a vote of the members, if the members vote to leave Tri-State, so be it".

Local control, cheaper prices, and flexibility with sourcing are what co-ops like LPEA hope to gain by leaving contracts with their current power suppliers.

But members who are against leaving Tri-State, like Ruggles, say that they are worried about the cost that will be put onto members and the potential volatility of being on the open market instead of in a consistent contract like with Tri-State.

The withdrawal from Tri-State comes with what some of these members see as more than a $200 million price tag."It's just too much debt, and they're not being transparent," said Ruggles to the Daily Yonder.

Hansen said that the money is a contract termination payment and not anything more than they were already contractually obligated to pay during their contract with Tri-State.

"It's not a punitive fine. It is the amount of debt we would have already had to pay if we stayed there," said LPEA board member Nicole Pitcher.

The payments are calculated by the Federal Energy Regulatory Commission (FERC) and are determined through a specific calculation that helps to maintain rate stability for the rest of Tri-State's members.

Moving Towards Renewables

Lee Boughey, VP of strategic communications for Tri-State, said that reliability and affordability are Tri-State's number one priorities. Boughey emphasized that Tri-State is owned and governed by its members - the distribution co-ops like LPEA all have representatives on the Tri-State board- and decisions like contracts are also dictated by the members. But part of that is allowing members to leave if Tri-State is not serving their own needs.

Rural electric co-ops are leading the way in energy innovation because of this member-driven governance. "It's part of the co-op model to respond to local demand and to do innovation," said Gilbert Michaud, a professor of environmental policy at Loyola University Chicago.

Tri-State is going through its own transition, led by the members. In 2020, Tri-State announced their Responsible Energy Plan, which laid out their plan to move away from coal and towards renewables like solar, wind, and hydroelectric power.

Boughey said that as renewable energy has become more affordable, generation and transmission co-ops like Tri-State have been able to invest in them more. "For cooperatives, reliability and affordability are critical, so it's only natural that you would see cooperatives add more renewables as those prices came down," he said.

Until recently, cooperatives haven't been on the same playing field as investor-owned utilities when it comes to developing their own utilities. As a non-profit organization, Tri-State does not have access to renewable energy tax credits that are available to for-profit companies. Rural electric co-ops are now able to take advantage of direct pay tax credits, the result of legislation passed in 2022.

"We're among the first cooperative utilities in the country to own large [scale] solar, so that's exciting," said Boughey.

However, for LPEA, leaving Tri-State is still the right option, according to Hansen. He also said that leaving will lower the co-ops cost of electricity immediately, putting less pressure on rates.

"We've got lower wholesale contracts on the day we leave. On April 1, 2026, our wholesale power costs will come down," said Hansen. Some of that power will be coming from power purchase agreements with Tri-State, different from the contract, which would have locked them into Tri-State's rates until 2050.

The total bill for members won't necessarily go down, because of other increasing costs like infrastructure, but Hansen added that "it takes the pressure off of our rate structure if your wholesale costs are flat or declining."

Boughey also said that Tri-State's wholesale contracts keep costs down for its members. He said their contracts allow for more consistency, whereas being on the open market could have more volatility. Tri-State's rates have grown 2.46% between 2017 and 2025.

A Trend Across the Country and the Region

Attempting to get out of traditional electricity contracts is not unique to Colorado.

In South Dakota, in 2023, the Eighth Circuit Court of Appeals upheld a decision by a federal judge that Dakota Energy Cooperative could not leave its contract with its wholesale power supplier, East River Electric Power Cooperative.

Dakota Energy Cooperative wanted to buy energy from Guzman Energy, a for-profit company out of Denver, Colorado, which has been a partner to many rural electric co-ops looking to leave their long-term contracts. But in South Dakota, this became a question of local vs out-of-state, with East River Electric taking the stance that local is better, even if it was coal-powered energy compared to the renewables that Guzman offered.

On June 1, 2025, Indiana electric co-op Tipmont left its contract with its power supplier, Wabash Valley Power Alliance, after multiple years of negotiations.

In the Southwest, four other electric co-ops have left contracts with Tri-State over the last decade. Kit Carson Electric Coop, in Taos County, New Mexico, was the first in 2016.

As of 2022, Kit Carson has reached 100% daytime solar energy-all generated locally-something they never could have done under the Tri-State contract.

Kit Carson CEO Luis Reyes, who has worked at the co-op for over 40 years, said starting in the early 2000s, the Kit Carson member owners were concerned about committing to long-term contracts with Tri-State, which at the time was primarily buying and producing coal-powered electricity.

"The co-op program has been great. I think it's the best model to deliver electricity to everybody with the members being the focal point," said Reyes."My opinion is we lost who the focal point was. We catered more to what Tri-State wanted than what our members wanted."

Reyes says since Kit Carson left in 2016, Tri-State has "really turned the ship," but in 2002 when Kit Carson first wanted to invest in renewables, "solar was bad," Reyes said, according to the board members of Tri-State at the time. But for Reyes, "it was good business, and it's what the members want." For Reyes and Kit Carson, leaving Tri-State was the way to accomplish their solar and renewable goals that the members wanted.

Kit Carson completed their $37 million contract termination payment in 2022 six years after formally withdrawing from Tri-State. That year, Kit Carson said their power rates were lower than any Tri-State member.

The pressures from members leaving, decreasing prices of renewables, and new voices at the table have brought Tri-State a long way from "solar was bad". Current contracts, which Boughey said have been signed by most members, increase the amount of local power that members can generate from 5% to 20%, giving members a lot more flexibility to develop their own utilities.

A lot has changed at Tri-State since Kit Carson left Tri-State in 2016, and Boughey said that any member has the ability to pursue leaving at any time, if the current policies aren't working for them. They continue to have good relationships with co-ops that have left, including LPEA which is in the process of leaving now.

"It's not a negative issue," said Boughey. "It's flexibility that our members want to have, that some members take advantage of, and we work very closely to execute those withdrawals in the spirit of the cooperative business model.


Ilana Newman wrote this article for The Daily Yonder.


get more stories like this via email

Despite debate in Washington over ending incentives to help Alaska's smallest places move away from traditional oil and gas-based power generation in the most remote parts of Alaska, one village above the Arctic Circle has found success and plans to invest.

Kotlik, a Yupik native village nestled on the banks of the Yukon River is using alternative energy as an economic driver.

Richard Bender, president and CEO of Kotlik Village Corporation, said the village has developed a three-phase plan to move away from oil and gas-based power to generate electricity for its 600 residents.

"Phase 1 is to purchase a battery storage system and switch gear," Bender outlined. "Phase 2 of Kotlik's energy plan is to produce energy using solar panels. Phase 3 is production of electricity using wind turbines."

Despite the success of places like Kotlik, and its aggressive plans for future alternative energy development, Washington lawmakers are debating a budget bill which would eliminate tax incentives for investing in clean power in rural Alaska, which could reduce funding for the projects the village depends on.

Kotlik collaborated with the Alaska Public Interest Research Group to produce a video about the project, which Bender noted goes beyond providing sources of alternative energy to the village.

"In addition to energy sovereignty, and sustainability, this project will have a positive impacts on health education and workforce development," Bender explained.

Bender added creating stability in those areas will spill over into different parts of the community and help the village keep people working at home, rather than moving to other places.


get more stories like this via email

The mayor of a rural Utah town said the clean energy investments and tax credits created by the Inflation Reduction Act are helping drive economic growth and diversify her town's energy portfolio.

Lenise Peterman, mayor of Helper, stressed tax credits have been vital for communities like hers as they help modernize their systems. But the budget reconciliation package now in Congress would eliminate major parts of Inflation Reduction Act funding, including clean energy investments.

Peterman said it could be detrimental to local people who have been able to harness the power of tax credits to grow their businesses.

"The jobs are there," Peterman emphasized. "We just need to ensure that we have the educational resources available - especially to people who may be transitioning out of a traditional coal plant or coal mining, to be able to step into those roles. But the roles are there."

She added while federal dollars in rural communities affect fewer people, their effect is triple that of urban communities. Peterman said the Inflation Reduction Act incentives will foster energy independence as power use and costs are projected to increase. Sen. John Curtis, R-Utah, has been an outspoken critic of sunsetting the credits.

Peterman pointed out Helper is in a unique position, since the town of about 2,200 residents owns and operates its own electric grid. It purchases power from transmission stations but Peterman said they face challenges due to the town's aging and limited infrastructure. She sees the tax credits as part of the solution.

"For me, it's about hardening the grid so that we can then incorporate other energy types, which I hope will drive costs down for the consumers," Peterman underscored. "Because now we'll have options and not be beholden to a single energy source."

Republican leadership in Congress is hoping to pass the big budget bill and have it signed by President Donald Trump before July 4. Peterman hopes politicians are able to reach consensus and do what is best for all, rural and urban alike.

"I'm hopeful that we can move past the partisan positions that people seem to be stuck in and do what's best for all of the people," Peterman added. "I really hope that comes to fruition."


get more stories like this via email