President Trump’s so-called “America First” budget actually puts millions of Americans last. Calling for a $54 billion increase in defense spending and a corresponding $54 billion cut for non-defense domestic agencies and programs in FY2018, this “America Last” budget cuts or entirely eliminates critical investments in infrastructure, science and technological research, community development in rural and metropolitan communities, clean air and water, and the health and education of American families.

America’s rural communities have long faced challenges with access to affordable health care insurance and services. Doctors and hospitals are farther away, higher poverty rates lead to worse health outcomes and lower coverage rates, and older populations result in more expensive coverage pools.

Republican responses to the nonpartisan Congressional Budget Office (CBO) finding that 24 million Americans will lose health insurance coverage under their plan revealed deep divisions among congressional Republicans about how best to proceed on health care. These divisions remain on display today as Republicans scramble to make changes to the American Health Care Act (AHCA) in a last-minute effort to pick up votes.

President Trump told the nation’s governors last month that “we’re going to start spending on infrastructure, big.” But so far, the Trump Administration’s only action has been to release a budget that slashes funds for roads and bridges, train service, airports and water systems.