President Lyndon B. Johnson knew the legislation he was about to sign was momentous, one that took courage for certain members of Congress to pass since the vote could cost them their seats.

To honor that, he took the unusual step of leaving the Oval Office and going to Capitol Hill for the signing ceremony. It was Aug. 6, 1965, five months after the "Bloody Sunday" attack on civil rights marchers in Selma, Alabama, gave momentum to the bill that became known as the Voting Rights Act.

In the six decades since, it became one of the most consequential laws in the nation's history, preventing discrimination against minorities at the ballot box and helping to elect thousands of Black and Hispanic representatives at all levels of government.

On Wednesday, the U.S. Supreme Court knocked out a major pillar of the law that had protected against racial discrimination in voting and representation. It was a decision that came more than a decade after the court undermined another key tenet of the law and led to restrictive voting laws in a number of states. Voting and civil rights advocates were left fearful of what lies ahead for minority communities.

"It means that you have entire communities that can go without having representation," said Cliff Albright, a co-founder of the group Black Voters Matter. "It is literally throwing us back to the Jim Crow era unapologetically, and that's not exaggeration."

Kareem Crayton, vice president of the Brennan Center for Justice's Washington office, said the court's steady work to erode the Voting Rights Act, culminating in Wednesday's decision, amounted to "burying it without the funeral."

The Supreme Court's ruling came in a congressional redistricting case out of Louisiana after the state created a district that gave the state its second Black representative to Congress.

It found that map to be an unconstitutional gerrymander because it took race into account to draw the lines. In an opinion written by Justice Samuel Alito, the court's conservative majority said the provision of the Voting Rights Act in question, called Section 2, was designed to protect voters from intentional discrimination.

Justice Elena Kagan in her dissent said the bar to show intentional discrimination is "an almost insurmountable barrier for challenges to any voting rights issues to prove discrimination."

Voting rights experts said the ruling leaves the Voting Rights Act only a shell of what it had been and will provide an open door for political mapmakers at every level — from local school districts to state legislatures to Congress — to undermine minority representation.

"We're witnessing the evisceration of America's greatest legislative landmark at the hands of a far right Supreme Court," Democratic U.S. Rep. Ritchie Torres of New York said.

Maria Teresa Kumar, president of Voto Latino, said the decision will allow more aggressive "cracking and packing" of populations to dilute their votes, "not just in congressional districts but also in state legislatures, county commissions, school boards and city councils."

Voting rights experts said there is no doubting the law's impact over the decades.

Sherrilyn Ifill, a law professor at Howard University and the former president of the NAACP Legal Defense Fund, said there were about 1,500 Black elected officials throughout the country in 1970. Today, that stands at more than 10,000.

"And it isn't because of the goodness of people's hearts," she said.

She said that success was a direct result of Black communities, civil rights activists and lawyers having the tools, through the Voting Rights Act, to file challenges to efforts to diminish the voting strength of Black and Hispanic voters. Most of the Section 2 cases have been over representation in local governments.

States will share $10 billion for rural health care next year in a program that aims to offset the Trump administration’s massive budget cuts to rural hospitals, federal officials announced Monday.

But while every state applied for money from the Rural Health Transformation Program, it won’t be distributed equally. And critics worry that the funding might be pulled back if a state’s policies don’t match up with the administration’s.

Officials said the average award for 2026 is $200 million, and the fund puts a total of $50 billion into rural health programs over five years. States propose how to spend their awards, and the Centers for Medicare and Medicaid Services assigns project officers to support each state, said agency administrator Dr. Mehmet Oz.

“This fund was crafted as part of the One Big Beautiful Bill, signed only six months ago now into law, in order to push states to be creative,” Oz said in a call with reporters Monday.

Under the program, half of the money is equally distributed to each state. The other half is allocated based on a formula developed by CMS that considered rural population size, the financial health of a state’s medical facilities and health outcomes for a state’s population.

The formula also ties $12 billion of the five-year funding to whether states are implementing health policies prioritized by the Trump administration’s “Make America Healthy Again” initiative. Examples include requiring nutrition education for health care providers, having schools participate in the Presidential Fitness Test or banning the use of SNAP benefits for so-called junk foods, Oz said.

Several Republican-led states — including Arkansas, Iowa, Louisiana, Nebraska, Oklahoma and Texas — have already adopted rules banning the purchase of foods like candy and soda with SNAP benefits.

The money that the states get will be recalculated annually, Oz said, allowing the administration to “claw back” funds if, for example, state leaders don’t pass promised policies. Oz said the clawbacks are not punishments, but leverage governors can use to push policies by pointing to the potential loss of millions.

“I’ve already heard governors express that sentiment that this is not a threat, that this is actually an empowering element of the One Big Beautiful Bill,” he said.

Carrie Cochran-McClain, chief policy officer with the National Rural Health Association, said she’s heard from a number of Democratic-led states that refused to include such restrictions on SNAP benefits even though it could hurt their chance to get more money from the fund.

“It’s not where their state leadership is,” she said. Oz and other federal officials have touted the program as a 50% increase in Medicaid investments in rural health care. Rep. Don Bacon, a Republican from Nebraska who has been critical of many of the administration’s policies but voted for the budget bill that slashed Medicaid, pointed to the fund when recently questioned about how the cuts would hurt rural hospitals.

“That’s why we added a $50 billion rural hospital fund, to help any hospital that’s struggling,” Bacon said. “This money is meant to keep hospitals afloat.”

But experts say it won’t nearly offset the losses that struggling rural hospitals will face from the federal spending law’s $1.2 trillion cut from the federal budget over the next decade, primarily from Medicaid. Millions of people are also expected to lose Medicaid benefits.

Estimates suggest rural hospitals could lose around $137 billion over the next decade because of the budget measure. As many as 300 rural hospitals were at risk for closure because of the GOP’s spending package, according to an analysis by The Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill.

“When you put that up against the $50 billion for the Rural Health Transformation Fund, you know — that math does not add up,” Cochran-McClain said.

She also said there’s no guarantee that the funding will go to rural hospitals in need. For example, she noted, one state’s application included a proposal for healthier, locally sourced school lunch options in rural areas.

And even though innovation is a goal of the program, Cochran-McClain said it’s tough for rural hospitals to innovate when they were struggling to break even before Congress’ Medicaid cuts.

“We talk to rural providers every day that say, ‘I would really love to do x, y, z, but I’m concerned about, you know, meeting payroll at the end of the month,’” she said. “So when you’re in that kind of crisis mode, it is, I would argue, almost impossible to do true innovation.”

The Supreme Court is meeting in private Friday with a key issue on its agenda — President Donald Trump ’s birthright citizenship order declaring that children born to parents who are in the United States illegally or temporarily are not American citizens.

The justices could say as soon as Monday whether they will hear Trump’s appeal of lower court rulings that have uniformly struck down the citizenship restrictions. They have not taken effect anywhere in the United States.

If the court steps in now, the case would be argued in the spring, with a definitive ruling expected by early summer.

The birthright citizenship order, which Trump signed on the first day of his second term in the White House, is part of his administration’s broad immigration crackdown. Other actions include immigration enforcement surges in several cities and the first peacetime invocation of the 18th century Alien Enemies Act.

The administration is facing multiple court challenges, and the high court has sent mixed signals in emergency orders it has issued. The justices effectively stopped the use of the Alien Enemies Act to rapidly deport alleged Venezuelan gang members without court hearings, while they allowed the resumption of sweeping immigration stops in the Los Angeles area after a lower court blocked the practice of stopping people solely based on their race, language, job or location.

The justices also are weighing the administration’s emergency appeal to be allowed to deploy National Guard troops in the Chicago area for immigration enforcement actions. A lower court has indefinitely prevented the deployment.

Birthright citizenship is the first Trump immigration-related policy to reach the court for a final ruling. Trump’s order would upend more than 125 years of understanding that the Constitution’s 14th Amendment confers citizenship on everyone born on American soil, with narrow exceptions for the children of foreign diplomats and those born to a foreign occupying force.

In a series of decisions, lower courts have struck down the executive order as unconstitutional, or likely so, even after a Supreme Court ruling in late June that limited judges’ use of nationwide injunctions.

While the Supreme Court curbed the use of nationwide injunctions, it did not rule out other court orders that could have nationwide effects, including in class-action lawsuits and those brought by states. The justices did not decide at that time whether the underlying citizenship order is constitutional.

But every lower court that has looked at the issue has concluded that Trump’s order violates or most likely violates the 14th Amendment, which was intended to ensure that Black people, including former slaves, had citizenship.

The administration is appealing two cases.

The U.S. Court of Appeals for the 9th Circuit in San Francisco ruled in July that a group of states that sued over the order needed a nationwide injunction to prevent the problems that would be caused by birthright citizenship being in effect in some states and not others.