If the Affordable Care Act’s enhanced premium tax credits are not extended, the effect on rural America will be severe and disproportionate, for both physical and mental health.

How severe? Nationally, allowing these credits to expire is expected to result in 4.8 million more uninsured individuals and dramatically lower ACA marketplace participation — by as much as 50 percent. This is especially consequential in mental health care, which depends heavily on coverage, particularly marketplace plans, which offer protections and essential benefits needed for access.

Rural Minds Founder & Chairman Jeff Winton and Barb Kalbach, a fourth-generation family farmer, registered nurse, and board member of Iowa Citizens for Community Improvement, were interviewed by host Andrew Peach on BBC World Service’s World Business Report, which reaches an estimated 100 million listeners worldwide, on Friday, October 3.

In addition to his role with Rural Minds, Jeff owns, operates, and farms Wall Street Dairy, LLC, a family dairy farm in Mayville, NY.

The two discussed the impact of tariffs on crop market stability and predicability due to trade disruption, the ongoing economic crisis in American agriculture, and how these challenges are affecting the mental health of farmers and rural communities.