My recent employer was one of the ISP providing rural telecom service. These subsidies accounted for a hefty percentage of our income and the company was still perpetually on the edge of failure. Most of our competitors were in similar situations, loaded down with breathtakingly large amounts of debt and expensive to maintain decaying infrastructure, much of it purchased from the Baby Bells when they got out of the market. I can't say that the company was particularly well run but am certain that without the government subsidies, the business would collapse and large numbers of rural customers would be without telecom services, which extend beyond just internet access.
Not sure what Starlink's existence is going to do to the company. Offering 25 Mbps aDSL with low reliability isn't going to compete very well if a customer can get 100 Mbsp service for a similar price and higher reliability. On the other hand, this might be justification the company can use to stop servicing the most expensive of the rural accounts to service while focusing on small town gigabit service that can compete with a reasonable expense to service.