What is the role of local public funding for rural health care? Building on prior work studying this funding stream in the state of Kansas, the researchers replicated their analysis in nine rural states. They tested their hypothesis that local public funding is more extensive than previously recognized by examining (1) the extent to which county tax expenditures are being used to fund local health care services in rural areas of the United States; (2) the factors that explain the extent to which counties will tax themselves to finance local health care services; and (3) which categories of services most commonly receive local public funding and under what conditions. This study informs policymakers about the role of public funding for rural health care systems and its impact on health delivery for vulnerable populations, especially the rural elderly.