Just 4 companies control almost all the fertilizer in America. Now the Kochs are planning a billion-dollar merger to drive up prices for farmers—and suffocate rural America—even more. The post This Billionaire Family is Suffocating Rural America appeared first on More Perfect Union .
Page F4From§Eachthe early bird edition — 2 September 2026
Republicans cite 500 new rural clinics as Medicaid proof; the family cornering fertilizer prices keeps cornering it.
As it ran on the front
The number Republicans are running with today: nearly 500 more healthcare facilities serving rural and low-income Americans in September 2026 than in July 2025, when Congress passed the One Big Beautiful Bill and cut Medicaid spending. Run that against the calendar and the number holds. Rural facility counts are up since the cuts. That is not in dispute.
What's missing from the release is the column next to it — the one measured not in doors opened but in dollars spent to keep a farm solvent enough to send a patient through one. In July 2024, thirteen months before the bill passed, reporting on rural America turned up a different set of numbers: four companies controlling almost all the fertilizer sold in this country, and one of those four, a billion-dollar family operation, moving to merge its way into controlling still more of it. The word used at the time was "suffocating." No correction has been filed on that word since.…
…(cont) So the ledger, reconciled: the same rural counties getting credit for 500 new clinics are, in the same stretch of time, paying whatever that fertilizer merger sets the price at. A clinic is a place people can afford to walk into. It says nothing about whether the crop that pays for the walk broke even this year. The growth column counts buildings. It does not subtract the input cost squeezing the household that funds the trip to the building.
This is not an accusation, hon. It's a reconciliation. The Washington Examiner's number and the fertilizer file are both accurate, both dated, and both about the same towns. One measures what opened. The other measures what got more expensive while it opened. Republicans are citing the first column to answer questions raised by the second, and the two columns don't share a line item.
Five hundred clinics is a real number. So is four companies controlling almost all the fertilizer in America. So is a billion-dollar merger among them. Put all three figures on the same page, dated correctly, and the rebuttal to the Medicaid warning stops rebutting anything. It just adds a fourth column nobody asked to see, filed under the same family name as the third.
“They hand you a press release with a good number on it and expect you to forget you can't afford to plant your own field. Four companies own most of the fertilizer in this country, and one of those families is still merging to own more of it while Congress calls rural health care fixed. Count the new clinics if you want — just count the fertilizer bill sitting next to them before you thank anybody.”
“Look at the number — nearly five hundred more facilities serving rural America since the bill passed, that's not spin, that's a count of doors. The cuts didn't close hospitals, they opened them, so maybe credit the bill instead of — wait, is that the same fertilizer market four companies and one family are merging their way further into? No, that's a completely separate ledger, don't conflate my hospital number with anybody's input costs.”
The receipts
Recent growth in the number of hospitals is undermining claims from Democrats that Republican cuts to Medicaid spending would cause a sweep of health facility closures. Nearly 500 more healthcare facilities are serving rural and low-income Americans this year than when the GOP passed its major health reform legislation in July 2025…
This page is a back-issue: the story as it ran, receipts as they were. The current edition is at the front.