How states could use the $50 billion they’re getting for rural well being : NPR

[ad_1] <img src="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/1024x683+0+0/resize/1100/quality/50/format/jpeg/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2Ff1%2F0c%2F5bfcb18b4f1ca248b41d59eae1cb%2Fgettyimages-2256600642.jpg" data-template="https://npr.brightspotcdn.com/dims3/default/strip/false/crop/1024x683+0+0/resize/{width}/quality/{quality}/format/{format}/?url=http%3A%2F%2Fnpr-brightspot.s3.amazonaws.com%2Ff1%2F0c%2F5bfcb18b4f1ca248b41d59eae1cb%2Fgettyimages-2256600642.jpg" class="img" alt="WASHINGTON, DC - JANUARY 16: (L-R) U.S. President Donald Trump speaks as U.S. Secretary of Health and Human Services Robert F. Kennedy Jr. and Administrator for the Centers for Medicare & Medicaid Services Mehmet Oz look on during a rural health roundtable on January 16, 2026 in Washington, DC." fetchpriority="high"/> U.S. President Donald Trump speaks as U.S. Secretary of Well being and Human Companies Robert F. Kennedy Jr. and Administrator for the Facilities for Medicare & Medicaid Companies Mehmet Oz look on throughout a rural well being roundtable on January 16, 2026 in Washington, DC. Chip Somodevilla/Getty Photos cover caption

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Chip Somodevilla/Getty Photos A nationwide experiment to present well being care in rural America a $50 billion makeover is underway.

The Trump administration, in a late December announcement, revealed how a lot every state will get underneath an formidable 5-year initiative referred to as the Rural Well being Transformation Program.

"This can be a huge effort to vary an unlucky actuality that has occurred to rural well being care in America," Dr. Mehmet Oz, head of the Facilities for Medicare and Medicaid Companies, instructed reporters because the awards went out, "which is that your zip code has began to foretell your life expectancy."

Analysis reveals individuals are extra more likely to die youthful in rural communities in comparison with cities, and the disparity has grown during the last three many years.

Congress created this new pot of cash final summer time. States got simply 52 days to tug collectively functions and description how they'd use the funding to enhance outcomes, develop the agricultural well being care workforce and drive innovation.

Every state is assured $100 million a yr over the following 5 years. The remainder of the cash was awarded primarily based on a sequence of things — together with how rural a state is, what states suggest to do with the cash and whether or not the states undertake insurance policies aligned with the administration's Make America Wholesome Once more priorities.

There's bipartisan pleasure about rural well being lastly getting some consideration and funding. Democrats and lots of well being coverage specialists argue, nonetheless, that this short-term $50 billion infusion pales compared to the roughly $1 trillion in cuts to Medicaid and Obamacare, additionally handed by Congress final yr.

"There's loads of nice issues in these proposals," mentioned Kevin Bennett, director of the Heart for Rural and Major Healthcare on the College of South Carolina. "However I believe if we actually needed to remodel [rural health care], they'd have gone lots additional."

Bennett spoke on a panel concerning the new funding co-hosted by the wholesome coverage new group Tradeoffs and the Leonard Davis Institute of Well being Economics on the College of Pennsylvania.

Listed below are a couple of different key issues to know concerning the Rural Well being Transformation Program:

Why was the Rural Well being Transformation Program created? Congress added the agricultural funding to President Trump's huge tax and spending invoice — generally referred to as the Large Lovely Invoice — handed by Republicans final July. On the final minute, Congress doubled the funds for this system from $25 billion to $50 billion.

The brand new funding was included partially to fulfill some Republicans lawmakers who feared that main cuts to federal Medicaid funding would threaten the viability of rural hospitals. Practically 200 rural hospitals have closed since 2005, and one other 432 are susceptible to closure, in accordance with a latest report.

However the Trump administration pushed states to suppose extra broadly about rural well being, telling them they will solely use as much as 15% of this new funding for direct funds to suppliers.

"The aim of this fund is to not pay working bills," Oz instructed reporters in December. "The aim of this $50 billion funding is to permit us to right-size the system and to cope with the elemental hindrances of enchancment in rural well being care."

How a lot cash did every state obtain? Awards for the primary yr vary from New Jersey's $147 million to $281 million for Texas.

Giant rural states like Texas, Alaska, California and Montana bought probably the most cash, however in accordance with an evaluation from the well being coverage analysis group KFF, some small states like New Jersey, Rhode Island and Massachusetts bought considerably extra per rural resident.

Paula Chatterjee, a doctor and researcher on the College of Pennsylvania did an evaluation forward of the awards being introduced that discovered what she referred to as a "mismatch" in how funds had been focused in comparison with the place the best rural affected person wants are.

"In case you take a look at the place funding per rural resident goes underneath this program, it is not going to states which have the best rural mortality charges," Chatterjee mentioned on the latest panel. "It isn't going to states which can be projected to have the best reductions in federal Medicaid spending. It isn't going to locations which can be dropping probably the most hospital beds."

How do states plan to make use of this funding? Quite a few states went after the brand new cash to fund extra telehealth, deploy synthetic intelligence and broaden the agricultural well being care workforce.

States took on workforce shortages from many angles. Delaware requested for cash to launch a brand new medical faculty. Alaska plans to spend funds on housing and little one look after its well being care employees. California desires to put money into a workforce mapping and planning instrument. Many states mentioned they'd create extra residency and fellowships for medical doctors and make it simpler for nurses, pharmacists and different well being employees to do extra.

"Plenty of the workforce proposals in these are tried and true strategies," Bennett mentioned. "Pipeline growth, incentive applications, mortgage compensation, all of these kinds of issues we all know could be efficient."

Will new rural funding make up for anticipated federal Medicaid cuts? The identical laws that created the Rural Well being Transformation Program additionally lower federal Medicaid spending by practically $1 trillion over the following decade. A KFF evaluation estimates that $137 billion of these cuts will hit rural areas — practically triple the quantity of the brand new rural well being fund.

Rural well being advocates say the looming cuts will depart hospitals struggling to outlive, making it tough to totally benefit from the agricultural funding alternative.

"It is actually laborious to consider transformation when you're attempting to maintain your doorways open and staff employed and sufferers served," Bennett mentioned.

What occurs subsequent? CMS launched an Workplace of Rural Well being Transformation, which is able to oversee this system and provide assist to states, in accordance with federal well being officers. Most states are planning to have their well being departments or Medicaid places of work handle their new initiatives.

States are anticipated to begin work on their implementation instantly, with awards for 2027 as a result of be introduced in October 2026.

A few of the cash comes with strings. States might get greater awards by promising to undertake well being insurance policies highlighted by the administration in its name for proposals.. But when states fail to move these insurance policies, they are going to obtain much less cash in future years and might be compelled to repay funds they already obtained.

In accordance with federal well being officers, 24 states promised to reinstate the Presidential Health Take a look at in faculties; thirty-three states mentioned they have already got or would add restrictions to their meals help applications to make it more durable for folks to purchase soda and different unhealthy gadgets; and 18 states bought factors for repealing or limiting certificates of want legal guidelines, which require well being care suppliers to show to state regulators that new companies or amenities are wanted earlier than they will open up store.