WASHINGTON (AP) — Director of National Intelligence Tulsi Gabbard told lawmakers in a letter Monday that she attended an FBI search of the elections hub in Fulton County, Georgia, last week because President Donald Trump asked for her to be there.
She also acknowledged that she “facilitated” what she described as a brief phone call between Trump and FBI agents who carried out the search but insisted that neither she nor the president had issued any directives.
The letter to top Democrats on the House and Senate intelligence committees marked Gabbard's first detailed explanation for her unusual presence at an FBI search during which agents armed with a warrant seized hundreds of boxes containing ballots and other documents related to the 2020 election in Georgia’s most populous county.
Fulton County, which votes overwhelmingly Democratic, has been a frequent target of the president's ire. He has long insisted without evidence that widespread voter fraud in the county cost him victory in Georgia in his 2020 loss to Democrat Joe Biden.
Gabbard's arrival in Georgia raised immediate questions among Democratic officials because the FBI search of the election center was a law enforcement, not intelligence, activity and because the position of national intelligence director is typically focused on foreign threats rather than domestic concerns.
In her letter, Gabbard said her presence was specifically requested by Trump and she accompanied senior FBI officials “under my broad statutory authority to coordinate, integrate, and analyze intelligence related to election security.”
Gabbard has been central to Trump administration efforts to cast doubt on intelligence community conclusions of Russian interference on Trump’s behalf during his successful 2016 campaign, and her presence in Georgia has been feared by Democrats as laying the groundwork for the federal government to assert that the 2020 race he lost was somehow tainted by foreign meddling or to cast doubt on the integrity of future elections.
Gabbard in her letter suggested that election systems are at risk of foreign interference, citing what she said was intelligence showing that electronic voting systems “have been vulnerable to exploitation” that could result in the manipulation of votes.
She said that in order to “preserve the integrity of our elections, we must understand whether there has been foreign or other malign interference in our elections, and whether vulnerabilities exist in our election infrastructure that could be exploited in future elections.” She did not explain why Fulton County was singled out for scrutiny, saying she had not seen the warrant that investigators submitted to a judge for approval.
Audits, state officials, courts and Trump’s own former attorney general have rejected the idea that there was widespread fraud in the 2020 election that could have altered the outcome. The 2024 election that Trump won was also seen as relatively trouble-free at the polls.
Gabbard also appeared to confirm a report earlier Monday from The New York Times that she had helped arrange a call between Trump and FBI agents. It is rare for a president to communicate directly with rank-and-file FBI personnel about specific investigations.
“While visiting the FBI Field Office in Atlanta, I thanked the FBI agents for their professionalism and great work, and facilitated a brief phone call for the President to thank the agents personally for their work. He did not ask any questions, nor did he or I issue any directives,” she wrote.
Director of National Intelligence Tulsi Gabbard, left, and FBI Deputy Director Andrew Bailey, enter a command vehicle as the FBI takes Fulton County 2020 Election ballots, Wednesday, Jan. 28, 2026, in Union City, Ga., near Atlanta. (AP Photo/Mike Stewart)
CREIGHTON, Neb. (AP) — Rick and Jane Saint John chose to live in the small town of Creighton, Nebraska, for one main reason: its hospital.
The couple has a child with nonverbal autism and epilepsy who requires up to three hospital visits a week. And Creighton's critical access hospital has been a lifeline for Jane: not only is she employed there, but three years ago, doctors saved her life when she contracted bacterial pneumonia. If she had waited another day for care, doctors said, her organs would have begun to shut down.
“And if we had had to drive the hour to the Yankton (South Dakota) hospital," Rick Saint John said, his voice breaking with emotion, "it could have cost her her life.”
So the Saint Johns were shocked to hear that Avera Creighton Hospital faces financial peril. A $50 billion government fund meant to transform rural health care will do little to help. It's a problem that millions of Americans in rural areas are awakening to as they realize there's no windfall coming for the vulnerable hospitals near their homes.
Hundreds of rural hospitals across the country are facing closures after years of funding problems. The issue was compounded last summer by the Trump administration's massive cuts to Medicaid, the government's safety net for low-income Americans, whose reimbursements have long helped hospitals meet their bottom lines.
Outcry over the funding cuts prompted Republican lawmakers to create $50 billion in new rural health grants, but critics say that funding is intended for innovative health care delivery solutions — not propping up hospitals buckling under current pressures.
“It won’t pay to keep the lights on. And it won’t turn the lights back on once they’ve been turned off,” said Dr. Ben Young, an infectious disease specialist and policy expert with public health advocacy group Wellness Equity Alliance.
Rural Americans’ health care worries reflect broader national concerns about access and rising prices of care as the cost of living spikes — anxieties that could prove pivotal in this year’s midterm elections.
The $50 billion Rural Health Transformation Program included in President Donald Trump's tax-and-spending law last year was billed by Republicans as a way to help hospitals in rural areas. Last summer, Health Secretary Robert F. Kennedy Jr. touted it as the “biggest infusion in history” for rural hospitals and pledged it will “restore and revitalize these communities.”
Hospitals and health industry experts have warned that while the fund — $10 billion per year allocated across all states for five years — offers some support to struggling rural hospitals, it won’t save them. One reason is that the sum doesn't come close to offsetting the $137 billion that rural hospitals expect to lose over the next decade, according to health research nonprofit KFF. Millions of people are expected to lose Medicaid benefits as a result of new Medicaid work requirements going into effect in 2027 — changes the Trump administration has maintained will crack down on fraudsters rather than cut off eligible enrollees.
Administrators say the new $50 billion fund is not meant to shore up ailing rural hospitals or maintain the status quo, but to transform rural health care through tech, workforce and other innovations. Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in a December video said it “gives states the tools to design solutions that last, not Band-Aids that fail.”
The White House echoed that Wednesday, saying the fund is intended to fund “big ideas” to improve rural health care access long-term.
“Decades of mismanagement by career politicians in Washington have left rural communities with limited care options," White House spokesman Kush Desai said.
State applications show a wide range of proposals. Some pitches sought to improve emergency medical services and modernize rural facilities, while others looked to make school lunches healthier, expand physical fitness programs, beef up telehealth and expand AI-driven technologies to help monitor patients.
Avera Creighton Hospital CEO Theresa Guenther argues her hospital is not in danger of closing. but conceded that Medicaid cuts will be painful — a sentiment shared by most rural hospitals, she said.
“Medicaid cuts will have an impact to us, and we — as well as many others — will have to figure out what that looks like moving forward,” she said. Her hospital hopes to get a piece of the $50 billion fund to help manage patients' chronic diseases — like diabetes — and to help cover workforce costs.
Nebraska, which received $218 million for the rural health grants' first installment, plans to spend some $90 million on healthier food options at schools, recruiting more health care workers and mobile sensors to remotely monitor chronically ill patients in rural areas, among other things. But for rural critical access hospitals at risk of closing, it offers $10 million to “right size” them by getting rid of inpatient care, where bed occupancy is typically low.
Republican state Sen. Barry DeKay said hospitals like Creighton's are vital, despite it's low occupancy rate. The hospital is in his district; even his mother received life-extending care there following a hip replacement. He's worried that the Medicaid cuts could hurt all the state's rural hospitals.
“I'll try to be working as hard as I can to get as much money to rural hospitals — whether it's in my district or any other rural district in the state,” he said.
Rick Saint John acknowledged he knows little about how Nebraska will use the federal funds, but he thinks it should go to helping hospitals like Creighton’s remain intact.
“The hospital is very important to this community, and for more than just medical care,” he said, citing job losses if the hospital loses services or closes.
The fund has seen pushback from hospital groups over an issue that's shaping up as important for 2026 voters.
The Colorado Hospital Association sent a letter in December to state lawmakers accusing them of ignoring input from rural hospitals during the application process.
The Nebraska Hospital Association, which endorsed Republican U.S. Sen. Deb Fischer’s 2024 reelection bid based on her advocacy for rural health care, has criticized both the cuts and the $50 billion fund. Fischer voted last summer for the Medicaid cuts.
That and other efforts by the state to limit Medicaid spending sends a message “that access to health care is not a priority," the group said.
Some Republican state lawmakers across the country have expressed unease with parts of the fund and have sought ways to use it to help struggling rural hospitals.
Under pressure, some rural states are making their own moves to help.
Wyoming enacted a law allowing rural hospitals to file Chapter 9 bankruptcy, normally reserved for financially stressed cities to reorganize debts and repay creditors while protecting them from legal action.
In North Dakota, during a special session to allocate the state’s federal rural health funds, the Republican-led Legislature passed an unrelated bill that aims to rescue a rural hospital with a low-interest loan of up to $5 million administered through the state-owned bank.
It's hoped the plan will keep the hospital open in a vast rural area where it employs 5% of the surrounding county's residents, hospital board member Matt Hager said.
Young, the expert with Wellness Equity Alliance, sees dark days ahead for rural hospitals.
“I am not optimistic in the short term,” he said. “Because these hospitals are facing immediate financial shortfalls, are barely financially operating currently, and they need operating support now.”
Swenson reported from New York. Associated Press writer Jack Dura contributed to this report from Bismarck, North Dakota.
Avera Creighton Hospital CEO Theresa Guenther is seen in her office, Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)
Nebraska State Sen. Barry DeKay, R-Niobrara, is seen on the floor of the Nebraska State Capitol, Feb. 5, 2026, in Lincoln, Neb. (AP Photo/Margery A. Beck)
Jane and Rick Saint John hold hands on Feb. 24, 2026, as they recall how Jane received life-saving care three years ago at Avera Creighton Hospital, in rural Creighton, Neb. (AP Photo/Margery A. Beck)
Jane and Rick Saint John discuss how important their local hospital, Avera Creighton Hospital, is in their rural community, Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)
Avera Creighton Hospital is seen on Feb. 24, 2026, in Creighton, Neb. (AP Photo/Margery A. Beck)
