How can Democrats reconnect with rural voters? Start with these issues.

In the 2018 midterm elections Democrats surprisingly gained votes in rural regions that went strongly for Trump in 2016. For nearly three decades, however, rural voters have voted increasingly Republican.

The few Democrats in Congress from country districts have long complained of their party’s minimal outreach to rural voters. In 2016 the Clinton campaign continued that trend expecting a large turnout in its favor among Hispanics, millennials, women, and urbanites. But as Clinton failed to revive “the Obama coalition” the rural vote for her reached a new modern low.

In 2008 and 2012 Obama had attracted 41 and 38 percent of rural and small-town voters. Clinton’s share dropped to 29 percent, a number that reflects not just political polarization with metropolitan voters, but also cultural, social and economic divides. A Pew survey found that inhabitants on both sides of a growing geographic-cultural rift believe those “others” look down on and disrespect them.

Democrats need to understand those resentments among country people in reaching out to them. More critically they need to recognize that while rural voters do not like Democrats, large majorities favor Democratic policies, as shown in a poll taken by the Daily Yonder, an online magazine that reports on “rural life for the people actually living it.”

The poll reflects rural people’s sense that their way of life is slipping away leading them to favor policies to protect their quality of life. More than 90 percent of voters in small towns and rural areas support investment in small businesses and preserving rural schools. Large majorities want hunting and fishing habitats protected, support for rural grocery stores with healthy food and for rehabilitation not prison for drug addicts.

Putting Democrats in office will give rural folks a better chance of realizing this wish-list.

Democrats should take notice specifically that majorities in rural areas support free tuition for community colleges (66 percent), expanding Medicare for all (63 percent) and raising the minimum wage (54 percent).

Democrats can reconnect to rural voters by taking on big corporations that hollow out small towns and agribusinesses that control the livelihoods of small farmers. The Obama administration issued a rule that would have allowed poultry growers, for example, to sue the large vertically integrated meat companies that regiment the entire production process. Under current law any farmer complaining of mistreatment must prove that the whole market is affected.

The Obama rule, yet to take effect, would have allowed individual farmers to show just the harm done to them. Trump received strong support from small farmers but in October 2017 his administration rescinded the Obama rule siding with lobbyists for Big Agriculture. Small farmer associations then filed suit to instate the Obama regulation.

In Arkansas the Republican legislature and governor in a special session responded to independent pharmacists who complained of price gouging by pharmacy benefit managers. The new law gave the Insurance Department oversight over the benefit managers aimed at increasing transparency of drug costs, lowering prices, and requiring the benefits network to provided “convenient patient access to pharmacies within a reasonable distance from a patient’s residence.” President Trump has made proposals to lower the costs of some high-priced drugs, one of which was struck down by a federal judge. Congress has begun grilling national pharmacy benefit managers once again against the backdrop of the Obama administration’s failure to lower skyrocketing prices in the face of fierce opposition from Big Pharma. Let’s not hold our breaths, but the Arkansas law provides a model for other states, one that Democrats should advocate.

Arkansas’s problem appears to be Kentucky’s as well. In 2018 the state fined CaremarkPCS $1.5 million for wrongful denial of pharmacists’ reimbursement claims. Recently the Kentucky Cabinet for Health and Family Services reported that PMBs—pharmaceutical middlemen—kept $123.5 million from health plans that cover the poor. Allegedly two PBMs paid pharmacists to fill prescriptions at a lower rate than they charge the state. Soaring drug prices concern all Kentuckians and support for and access to pharmacies matter particularly to rural people.

Oh, and Democrats, let rural people know you want to do something about the scourge of opioids, heroin, meth, and fentanyl ravaging lives and communities. In the 2018 Sixth District Congressional election Democrat Amy McGrath carried just two counties, Fayette and Franklin, doing best in the counties of the Lexington-Frankfort axis. Although she lost heavily in the most rural and poorest counties, McGrath who campaigned through the entire district, won more votes in 16 out of 18 counties than Clinton in 2016. Letting people know you want their votes is a good start.

Ron Formisano is the author of “American Plutocracy: The Permanent Political Class” (University of Illinois Press, 2017)