States across America are learning that the pity funding Republicans just handed them will come nowhere close to fixing the rural health care crisis Trump and the GOP created last year. Since jamming their Big, Ugly Bill through Congress, Washington Republicans have pointed to this pot of rural health funding to obscure the fact they decimated Medicaid and left millions of Americans without health insurance. But the $50 billion rural health fund is nothing more than a flimsy bandaid over the $137 billion rural hospitals are estimated to lose due to Republican health care cuts. As news stories from the forests of Washington to the farmlands of Virginia reflect, rural patients and health care providers know they’re being ripped off by a Republican Party that pads the wallets of its biggest donors while leaving the most vulnerable rural Americans floundering in a sea of hospital closures and skyrocketing health care premiums.
IN THE NEWS
Arizona
- “‘The administration is shortchanging rural Arizonans in failing to give our communities the support they need to blunt the devastating impacts of the federal attacks on health care,’ Hobbs spokesperson Christian Slater wrote in a Dec. 30 email to The Arizona Republic.”
- “‘This funding is woefully inadequate and resoundingly fails to address the health care crisis, a crisis of the GOP’s own creation,’ Morgan Finkelstein of Protect Our Care Arizona wrote in a Dec. 30 email to The Republic.” [Arizona Republic]
Arkansas
- “While Oz lauded the awards as ‘an extraordinary milestone for rural health in America,’ many policy experts have noted the money will only offset a fraction of the Medicaid cuts included in the Trump megabill.”
- “‘More Arkansans are going to be uninsured, which means we are making the issues that rural hospitals are dealing with even harder, because the reality is that many of them are not operating in the black,’ said Keesa Smith-Brantley, executive director of Arkansas Advocates for Children and Families. ‘The more uninsured that come to them, the more problematic it’s going to be for their bottom line.’” [Arkansas Democrat-Gazette]
Georgia
- “But critics say the program won’t make up for drastic Medicaid funding cuts enshrined in the ‘one big, beautiful bill’ that Trump signed into law over the summer. According to a new report from the Georgia Health Initiative, the state will lose an estimated $5.4 billion in Medicaid funding over the next 10 years as a result of the legislation, and 460,000 people will become uninsured.
- “Leah Chan, director of health justice at Georgia Budget and Policy Institute, said […] ‘What we can see from the application is, in fact, these rural health transformation funds do not address the loss of these federal provider payments’ […]. ‘So essentially, our state is left to pick up the tab.’” [Georgia Recorder]
Illinois
- “‘Federal funding is critical and welcomed,’ Governor JB Pritzker said in a statement, ‘but this comes as Donald Trump and his disastrous budget bill strip billions from rural healthcare providers and threaten rural healthcare access for our residents—an overall loss that cannot be ignored.’”
- “‘This is a welcome and necessary stopgap,’ [Representative Nikki] Budzinski said, ‘but it is simply not enough to address the strain rural healthcare providers are facing.’” [Chicago Crusader]
Indiana
- “The money is part of a five-year, $50 billion program specifically meant for investing in rural health initiatives as part of President Donald Trump’s One Big Beautiful Bill Act passed in July. […] This is the same law that made massive cuts and policy changes to Medicaid in an effort to pay for the bill’s trillions of dollars in tax cuts. Senators added this $50 billion rural health fund late in the process to sweeten the deal for Republicans who were uneasy about the Medicaid cuts.” [Indy Star]
Louisiana
- “But health care experts have warned the federal government’s $50 billion rural health care fund will not be enough to make up for massive cuts to the national Medicaid program over the next decade. Those reductions, pushed by Trump, will disproportionately impact rural hospitals because their patients are more likely to have low incomes and rely on Medicaid for health insurance.” [Louisiana Illuminator]
Michigan
- “The federal government has awarded Michigan $173 million to support rural health providers from a fund created last year to help offset cuts to Medicaid in President Donald Trump’s domestic policy bill.”
- “Last summer, MDHHS estimated that the One Big Beautiful Bill’s revisions to provider tax rates and state-directed payments, which help fund the state’s Medicaid programs, would cut $2.5 billion from Michigan health care providers when the changes are fully implemented.” [Detroit News]
Missouri
- “Missouri will receive $216 million during the 2026 fiscal year, the Centers for Medicare and Medicaid Services announced Monday. […] Under H.R. 1, Missouri could lose an estimated $23 billion in federal funding over the next decade, the Missouri Foundation for Health estimates. The rural health fund was introduced as a way to offset some of the cuts set forth in the budget bill, but experts warn that the Medicaid cuts could still have massive negative impacts on rural communities.”
- “‘It’s by no means a direct replacement. The total amount of dollars is not the same,’ [Senior Policy Adviser at the Robert Wood Johnson Foundation Katherine] Hempstead said. ‘These Medicaid cuts are permanent, and this Rural Health Transformation Fund is sort of a one shot.’” [Beacon News]
- “Missouri received the ninth-largest award of any state from the federal Rural Health Transformation Program, part of the GOP spending law passed by Congress over the summer. But it still amounts to less than a third of what rural areas will lose from reduced Medicaid spending.” [KCUR]
Nevada
- “The nonpartisan health research organization KFF found that the Rural Health Transformation Program would only offset a little more than one-third of the Big Beautiful Bill’s estimated $137 billion cut to federal Medicaid spending in rural areas over the next decade.”
- “Nevada’s allocation, $179.9 million, ranked 42nd of the fifty states.” [Nevada Current]
North Carolina
- “But even the state said $1 billion won’t be enough. ‘In North Carolina over the next 10 years we expect to lose as much as $49 billion as a result of HR1 so… we could use a lot more,’ [North Carolina Deputy Secretary for Health Debra] Farrington said, referring to Trump’s legislation. Farrington tells Spectrum News 1 they are worried about the financial outlook for rural hospitals. ‘We are concerned… and that’s part of the reason we designed the initiatives in the way that we did, because we want to provide support to rural hospitals so that they can remain open and available to the citizens that rely on them,’ Farrington said. [Spectrum News 1]
Oregon
- “Democratic lawmakers criticized the Rural Health Transformation Program as a ‘bandaid for a bullet hole,’ according to statements from U.S. Sen. Jeff Merkley and U.S. Rep. Andrea Salinas. U.S. Rep. Maxine Dexter, also an Oregon Democrat, said it was ‘like throwing someone a life jacket after sinking their ship.’”
- “‘Let’s be clear here, the reason this funding is needed at all is because Rep. Bentz and President Trump […] made massive cuts to rural healthcare and jacked up healthcare costs for Oregonians with their ‘trash bill,’ H.R. 1.,’ [Koray Rosati, a spokesperson for Rep. Janelle Bynum] said in an email. ‘They sold our rural communities out and now they want credit for offering pennies in return.’” [Oregon Capital Chronicle]
South Dakota
- “Governor Larry Rhoden yesterday announced that the federal Department of Health is giving South Dakota $189.4 million to subsidize rural health care. The money comes from the five-year, $50-billion Rural Health Transformation Program, part of the big ugly budget bill Congress passed in July.”
- “But […] Medicaid losses in South Dakota may total over $840 million, more than quadruple the restricted-use RHT funding announced for South Dakota Monday and more than the $500 million total in RHT money that Governor Rhoden’s FY2027 budget anticipates.” [Dakota Free Press]
- “South Dakota received about $11 million less than what it requested from a new federal rural health fund, and the amount is smaller than the awards for surrounding states.” [South Dakota Searchlight]
Vermont
- “The state’s insurance premiums are among the highest in the nation, and its rural hospitals are increasingly financially precarious.”
- “In the end, Vermont could lose more than it gains under the law: KFF, a nonpartisan health care researcher, has estimated that Vermont could lose between $1 billion and $2 billion over 10 years from changes to Medicaid.” [Vermont Public]
Virginia
- “The funding arrives as rural providers face mounting pressure from changes to Medicaid and insurance coverage, but key questions remain about how the funds will be divided among initiatives and whether the short timeline will allow programs to deliver measurable improvements before future allocations are reassessed.”
- “The transformation fund will end at the end of 2030, raising questions nationwide about what happens to programs once the money runs out.” [Cardinal News]
Washington
- “But critics of the plan argue that the funds will not be enough to replace losses to Medicaid approved in the “One Big Beautiful Bill. Based on Congressional Budget Office analysis, rural Medicaid spending would be cut by $137 billion over the next 10 years, meaning the $50 billion fund would cover 36% of the anticipated losses.”
- “Despite being the 13th most populous state in the nation, Washington will receive the 10th least amount of money of all states. Though Washington has high population centers like Seattle, the state also has a large rural population. According to the state Health Care Authority, approximately 1.1 million Washington state residents live in rural counties, which makes up 14% of the state’s population.” [The Spokesman-Review]
West Virginia
- “The fund comes from the Big Beautiful Bill, at the same time as major Medicaid cuts. According to [West Virginia Hospital Association President and CEO Jim] Kaufman, those cuts could total to about one billion dollars a year for West Virginia. Kaufman said the Rural Health Transformation Fund will help mitigate those losses, but won’t come close to covering them.”
- “‘These are not replacement dollars,’ Kaufman told WSAZ. ‘The $199 million a year is a great opportunity to transform rural health care in West Virginia, but it is not replacement dollars for the billion dollars a year that West Virginia hospitals stand to lose if all those cuts are fully implemented.’” [WSAZ]
- “This week, West Virginia learned that the state has secured $199 million the coming year from the Rural Health Transformation fund. Yet West Virginia hospitals are anticipated to lose about $1 billion a year in Medicaid funding when the One Big Beautiful Bill legislation is fully implemented.” [Metro News]