As a candidate, President Donald Trump promised to focus on revitalizing predominantly rural and small-town industries across America, claiming that “[f]amily farms are the backbone of this country” and that “coal is coming back.” President Trump visited these small towns and rural areas promising voters he would “create massive numbers of jobs” and that he would “rebuild … your communities.” But the agenda that Trump is advancing—reflected in his “skinny budget” released today as well as in his reported past policy proposals and statements—reveals his bait and switch on voters in these very communities.

It was clear that President Trump’s promises never extended to the millions of Americans who live in small towns and rural areas. He did not, for example, visit or speak to the concerns of tribal reservations, predominantly African American communities in the Mississippi Delta, or largely Latino farming communities. And yet many rural and small-town voters responded favorably. These voters—specifically white rural voters—overwhelmingly chose Trump.

New analysis by the Center for American Progress shows that in the rural and small-town counties that President Trump won, one-third of families live paycheck to paycheck—a rate that is 24 percent higher than in urban counties.* And in some states, the rate is even higher. (see Table 1) But the agenda Trump and conservatives in Congress are pursuing harms the very people who elected him. In particular, Trump’s proposal to increase defense spending by $54 billion in 2018—paid for by slashing $54 billion from the nondefense discretionary budget—would necessitate a 13 percent across-the-board cut if applied equally across programs and would devastate many programs that are critical to rural and small-town communities. But his budget is just the tip of the iceberg. Many critical services and vital programs at risk under the Trump administration are not explicitly targeted for cuts or elimination in his budget, but the threat to them is very real. Here are 10 ways in which the Trump agenda will hurt the job prospects, health, basic living standards, and safety of the rural and small-town voters who elected him.

Hurting job prospects

President Trump favors tax breaks for Wall Street over infrastructure investments in hard-hit rural communities. During his joint address to Congress, Trump repeated his oft-cited campaign promise to invest in infrastructure, calling for a bill that “produces” $1 trillion in infrastructure improvements. This phrasing is code for enacting tax cuts for Wall Street investors instead of supporting local communities with essential funding. Trump’s plan would leave out rural and small-town communities because many of their sorely needed infrastructure projects—such as rehabilitation of aging nontoll bridges and roads or their fraying water and sewage systems—would not generate sufficient revenue to attract the interest of investors. Thus, these crucial repair and maintenance projects are unlikely to take place under the Trump plan, leaving rural communities further behind. In addition, Trump’s newly released budget slashes nearly $2.6 billion in infrastructure investments, half a billion dollars of which goes to rural water and sewage improvements.

President Trump’s agenda will cost rural areas and small towns clean energy job opportunities. Trump opposes federal subsidies for wind energy, despite the fact that wind power creates clean energy, good jobs, and economic growth. The U.S. wind power industry has rapidly grown in recent years and has the potential to be a powerful economic engine in rural America—if properly supported. According to the latest U.S. Department of Energy figures, the wind energy industry provides more than 102,000 jobs throughout the nation, many of which are located in rural communities. New data released by the American Wind Energy Association find that U.S. wind farms pay $222 million each year to farming families and other rural landowners, with more than $156 million of this going to landowners in counties where incomes are below the national average. Failing to invest in this critical energy source is also a failure to invest in rural economic growth.

Rural economies are hurt by President Trump’s scaremongering on immigration. Trump’s fear campaign, divisive rhetoric, and direct threats to immigrant communities hurt local economies in rural areas. Immigrants perform essential roles in the rural economy and increase these communities’ tax bases. In the rural counties of states such as Georgia, North Carolina, Minnesota, and Florida, immigrants work in a variety of industries ranging from manufacturing to agriculture to meatpacking. Small businesses started by immigrant and refugee entrepreneurs are also revitalizing small towns all over the country. For example, the mayor of West Liberty, a small town in rural Iowa, attributes its survival to immigrants. And West Liberty is not alone—research shows that immigrant businesses bring essential tax revenues, job growth, and downtown revitalization to rural towns.

Harming health

President Trump’s plans will reduce the affordability of and access to quality health care. Trump has promised to provide health “insurance for everybody,” but he supports dismantling the Affordable Care Act, or ACA, and replacing it with congressional Republicans’ American Health Care Act, which the nonpartisan Congressional Budget Office estimates will cause 24 million Americans to lose their coverage by 2026. This plan, which would increase costs for the average insured American by $2,409 per year by 2020, would particularly harm rural areas, which have unique challenges in providing health care. The ACA repeal would threaten the long-term funding of roughly 1,300 community health centers, many of which are located in rural communities and serve as a primary source of health care services in areas with a long history of medical care scarcity. Rural communities and hospitals will especially suffer from repeal due to the projected increase in uncompensated care and because the ACA has played a central role in incentivizing health care practitioners to move to and serve small towns that have long struggled to attract and retain health providers. Trump’s budget and hostile immigration ban will only make the doctor shortage worse, as foreign-born doctors who come to the United States are more likely to practice in underserved communities, many of which are in rural areas. And the administration proposes to slash $403 million in programs that help train and sustain rural primary care providers, including nurses and physician assistants.

President Trump’s plan will worsen the opioid epidemic. Opioid addiction, which rips apart families and communities and cost more than 30,000 Americans their lives in 2015 due to overdoses, has been called the “worst drug crisis” in American history. While the epidemic affects every corner of the country, rural areas and small towns have been hit particularly hard. Despite Trump’s campaign pledge to give people with addiction “access to the care and the help” they need, his administration’s policies would make the epidemic far worse. While his budget pledges $500 million to tackle opioid addiction, that cannot begin to reverse the damage caused by his administration’s and congressional Republicans’ efforts to strip Americans struggling with addiction of their health care coverage. Repealing the ACA would cost approximately 222,000 people with an opioid addiction at least some of their health insurance coverage, and Trump’s plan to cut Medicaid could severely reduce access to treatment. While not addressed in this budget, Trump’s earlier reported proposal to eliminate the White House’s Office of National Drug Control Policy would also drain critical resources from the fight.

Cutting basic living standards such as education, affordable housing, and nutrition

President Trump’s plan would also reduce the quality of schools. Trump’s secretary of education, Betsy DeVos, supports vouchers, virtual schools, and other education policies that will harm students in rural areas and small towns. The most rigorous and comprehensive research on vouchers finds that they negatively affect student achievement, but the impact of a nationwide voucher initiative would be particularly devastating in rural communities and small towns where there are not enough students to sustain multiple schools at each grade span. In these communities, a voucher initiative would threaten the stability and finances of the public school system and undermine the performance of all schools in the area. Virtual schools, which are often suggested as a solution to limited course options in rural and small-town schools, have been linked to poor academic results and high levels of attrition. Yet Trump’s budget would increase funding by $1.4 billion in 2018 for failed so-called school choice policies such as vouchers—while slashing 15 cents of every $1 that goes toward successful Department of Education initiatives such as teacher training, federal work-study, and after-school and summer-school programs for low-income students.

President Trump will make housing less affordable. Communities across America are facing severe shortages of affordable housing, with some families unable to find an affordable place to rent or buy and many families constantly under the threat of foreclosure or eviction. Rural communities’ fight for more fair and affordable housing stands to suffer substantial setbacks under Trump’s agenda. The president’s severe budget cuts threaten the vital role that the federal government plays in providing, supporting, and protecting safe, affordable housing. The more than $6 billion in cuts eliminates the very programs and funding—such as the Community Development Block Grant—that allow rural communities to repair crumbling housing stock; help seniors, veterans, and struggling individuals and families stay in their homes; and maintain critical infrastructure systems that preserve residents’ access to clean water and protect them from toxic waste. While Trump’s budget cuts the U.S. Department of Agriculture’s, or USDA’s, budget by more than 20 percent, it does not specify whether or by how much it would cut USDA rental assistance. Even a 10 percent cut could put about 27,000 families at risk of homelessness. Trump’s budget also eliminates the Low Income Home Energy Assistance Program; the Community Services Block Grant; and NeighborWorks America, which supports neighborhood organizations that develop and maintain affordable housing. The slashing of programs such as NeighborWorks America would particularly affect rural communities, as more than two in three community development groups that rely on its funding serve rural America.

President Trump’s plans will worsen hunger for rural children and seniors. More than 3 million people living in rural areas—disproportionately seniors and children—turned to the Supplemental Nutrition Assistance Program, or SNAP, in 2015 to help them afford enough food. Research shows that during the recent recession, SNAP was especially important to rural communities because a higher percentage of households in rural areas—which faced greater rates of family economic insecurity—benefited from the program compared with their nonrural counterparts. Reports that Trump is relying on the conservative Heritage Foundation’s blueprint indicate that SNAP could face steep cuts, and members of Trump’s administration, including Secretary of Health and Human Services Tom Price, have previously advocated for slashing SNAP. Cuts to SNAP, which is one of our nation’s most effective investments to help families make ends meet and boost economic activity during tough times, would increase food insecurity and hurt local economies in rural areas. Moreover, Trump’s plan to cut nondefense discretionary spending by $54 billion could be devastating for other vital food security programs. His budget severely cuts Meals on Wheels; slashes $200 million from the Special Supplemental Nutrition Program for Women, Infants, and Children, otherwise known as WIC; and threatens other nutrition initiatives with a 21 percent cut to the USDA.

Reducing access to justice and jeopardizing safety

President Trump’s agenda could lead to an increase in domestic violence. In the decade and a half after the passage of the Violence Against Women Act, or VAWA, intimate partner violence declined by nearly two-thirds. Despite this dramatic improvement, VAWA grants could be targeted for serious cuts. While the budget is silent on the future of VAWA grants, an overall 4 percent cut to the Department of Justice, or DOJ, coupled with dramatic increases to other DOJ programs, such as incarceration and deportation efforts, does not bode well. Trump’s reported reliance on the Heritage Foundation’s budget blueprint suggests he may eliminate VAWA grants that support programs and services dedicated to survivors of violence. Eliminating them would be harmful for survivors in rural areas, who have particular challenges when seeking assistance—including physical isolation and transportation difficulties. This is why the DOJ’s Office on Violence Against Women, or OVW, has a program targeting rural survivors of violence that is slated to provide an estimated 50 grants worth $33 million in fiscal year 2017 to increase survivors’ safety and well-being. A 13 percent cut to total OVW grant funding would force grantees to turn away approximately 90,000 survivors each year from receiving vital services and protections—and even just a 4 percent cut could leave nearly 30,000 survivors without critical services. Failure to provide these often lifesaving resources will jeopardize rural families and survivors of domestic violence.

President Trump’s plan would slash funding for legal aid services. Trump’s intent to eliminate all funding for the Legal Services Corporation, or LSC, would reduce access to justice for rural Americans. The LSC provides funding to 134 legal aid programs that serve low-income Americans in every congressional district—but its work is particularly important for rural communities and small towns, where legal representation is often lacking and which the LSC has identified as high-need areas. For example, in Texas, a state with many rural communities, the three main legal aid service providers serve nearly 140,000 low-income people—including almost 62,000 children—ensuring vital legal protection against wrongful eviction and denial of public assistance and services, among other civil injustices. If the LSC were eliminated, these providers, which rely on the LSC for at least half of their funding, would be forced to scale back on services. This would almost inevitably undermine access to justice; increase the incidence of domestic violence; and increase homelessness, including among veterans.

Conclusion

President Trump and congressional Republicans are advancing an agenda that will harm the job prospects, health, education, housing, and safety of all Americans. But given his campaign focus on helping struggling Americans in rural communities and small towns, his policy agenda as president is an egregious bait and switch, as his budget clearly sells out America’s most vulnerable rural communities, including Appalachia and the Mississippi River Delta region, farmers, and tribal nations.

* Methodological note: We define “living paycheck to paycheck” as having a family income below 200 percent of the federal poverty line. The analysis combines demographic and income data from the 2015 American Community Survey 5-year Estimates with 2016 voting data from the Atlas of U.S. Presidential Elections, which tracks election outcomes in all counties except those in Alaska and a handful of other counties around the country. We use the U.S. Department of Agriculture’s 2013 Rural-Urban Continuum Codes to separate counties into nine categories—three metropolitan and six nonmetropolitan—based on population size, degree of urbanization, and adjacency to a metro area. We consider as “rural” or “small town” counties classified as five or higher, which excludes all metro areas as well as urban areas with populations greater than 20,000 that are adjacent to a metro area. Based on this analysis, rural and small-town counties account for 1,735 counties in the sample and are home to an estimated 11 percent of eligible voters. President Trump won 1,579 of these counties in the 2016 election.

Katherine Gallagher Robbins is the Director of Family Policy for the Poverty to Prosperity Program at the Center for American Progress. Rejane Frederick is an Associate Director for the Poverty to Prosperity Program. Rachel West is an Associate Director for the Poverty to Prosperity Program.