Fresh off the 2025 Legislative Conference, here are five takeaways that will shape our work as intergovernmental partners in the months ahead.

Estimated read time: 3 min.

Protecting the tax-exempt status of municipal bonds

Counties rely on tax-exempt municipal bonds to fund critical infrastructure projects like roads, bridges, hospitals and water systems. Removing this tax exemption would increase borrowing costs, forcing local governments to cut investments or raise taxes.

• By the numbers: States and local governments fund 75% of U.S. transportation and water infrastructure.
• Cost impact: Eliminating the exemption would drive up borrowing costs for counties, and potentially increase taxes for residents.
• Take action: Contact your members of Congress and urge them to oppose eliminating the municipal bond tax exemption.

Reauthorizing the Secure Rural Schools (SRS) program

The expiration of the SRS program puts over 700 rural counties at risk of significant budget cuts, jeopardizing funding for education, roads and emergency services.

• Severe funding cuts: Counties face an 80% reduction in forest revenue-sharing payments without reauthorization.
• Critical services at risk: Education, infrastructure and emergency services could suffer major setbacks.
• Legislative push: Urge Congress to pass the Secure Rural Schools Reauthorization Act (H.R. 1381/S. 356).

Preserving Medicaid’s federal-state-local partnership

Proposed federal cuts to Medicaid financing could shift billions in costs to counties, threatening healthcare access for millions of residents.

• County role: Counties operate over 900 hospitals, 700 long-term care facilities, 750 behavioral health authorities and 1,900 public health departments.
• Impact of cuts: Reduced funding could limit access to essential healthcare, especially for those with substance use disorders.
• Advocacy in action: NACo is educating lawmakers on how Medicaid financing changes would impact county finances and community health.

Strengthening disaster response and recovery

Counties are on the frontlines of disaster response, but outdated and underfunded federal programs slow recovery efforts. NACo’s Intergovernmental Disaster Reform Task Force is pushing for critical reforms to improve disaster assistance.

• Key priorities: Priorities include faster FEMA reimbursements, better coordination and streamlined federal processes.
• Local leadership: Given our central role when it comes to disasters, counties need a seat at the table in federal disaster policy discussions.
• Advocacy in action: At the 2025 Legislative Conference, the task force held a briefing on Capitol Hill. Check out the video highlights.

Expanding access to rural health and EMS services

With 80% of counties facing ambulance service gaps, rural EMS access remains a critical concern. NACo is advocating for legislative solutions to strengthen these services.

• Advocacy goals: Objectives include focusing on improved reimbursement rates and support for rural hospital programs and advocating for expanded telehealth access to serve rural communities.
• Federal action needed: NACo is urging Congress to prioritize rural health and EMS service improvements.