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A ranch owner brings in a load of hay from her ranch in Texas in 2024. Experts and lawmakers worry a new $50 billion program designed to help struggling rural health care providers may not be enough to offset federal funding losses. (Scott Olson\/Getty Images)<\/p>\n
Congress set aside $50 billion for rural hospitals and medical providers to allay fears over the billions more in historic cuts to federal health care spending that President Donald Trump signed into law on Independence Day.<\/p>\n
But is that bandage big enough to save struggling rural hospitals?<\/p>\n
\u201cI have more questions than I have answers,\u201d said Alan Morgan, CEO of the National Rural Health Association, a nonprofit policy group. \u201cNo one has those answers yet.\u201d<\/p>\n
Morgan noted that the new money for rural health, to be spent over five years, is far less than the $155 billion in rural Medicaid spending cuts over 10 years, as estimated<\/a> by KFF, a nonprofit health policy and research group.<\/p>\n Experts, hospital leaders and lawmakers on both sides of the aisle fear that Trump\u2019s signature legislation will particularly gut rural hospitals and clinics, which see an outsize share of patients who are insured through Medicaid, the federal-state public health insurance for people with low incomes. The new law slashes more than $1 trillion from Medicaid over the next 10 years to help pay for tax cuts that disproportionately benefit the wealthy.<\/p>\n States scramble to shield hospitals from GOP Medicaid cuts<\/a><\/p>\n<\/blockquote>\n The $50 billion addition was an effort by Republican leaders in Congress to win the votes of colleagues within their party who initially balked at supporting such steep cuts to Medicaid and other health services.<\/p>\n In the U.S. Senate, the rural program helped<\/a> secure the vote<\/a> of Alaska moderate Republican Sen. Lisa Murkowski, who expressed concern about the law\u2019s impact on health care in her state. About 1 in 3 Alaskans<\/a> are insured through Medicaid.<\/p>\n Jared Kosin, the president and CEO of the Alaska Hospital & Healthcare Association, said he\u2019s deeply frustrated with the new law\u2019s gutting of Medicaid funding, which he thinks will wreak lasting damage on Alaskans. And Republicans sidestepped potential solutions by just throwing money into a program, he said.<\/p>\n \u201cIt\u2019s frustrating in the public realm when decisions like this are made fast and, frankly, carelessly,\u201d he said.<\/p>\n \u201cThe consequences are going to fall on us, not them.\u201d<\/p>\n More than half of the law\u2019s cuts to funding in rural areas are concentrated in 12 states<\/a> with large rural populations that expanded Medicaid under the Affordable Care Act to cover more people, according to KFF: Illinois, Kentucky, Louisiana, Michigan, Minnesota, Missouri, New York, North Carolina, Ohio, Oklahoma, Pennsylvania and Virginia.<\/p>\n Some<\/a> GOP lawmakers<\/a> in Congress have heralded the $50 billion rural program as a health care victory. But it\u2019s still unclear which hospitals, clinics and other providers would receive money and how much.<\/p>\n \t<\/p><\/strong><\/h4>\n The Rural Health Transformation Program will dole out $10 billion annually from fiscal years 2026 through 2030.<\/p>\n States must apply for their funding by the end of this year, submitting a detailed plan on how it would be used.<\/p>\n The law outlines some ways that states can use the money, according to an analysis<\/a> of the legislation from the Bipartisan Policy Center:<\/p>\n Half of the $10 billion each year will be distributed evenly across states that have applied for it. The other half can be distributed by the administrator of the federal Centers for Medicare & Medicaid Services \u2014 currently Dr. Mehmet Oz \u2014 at his discretion, based on a state\u2019s rural population and rural health facilities.<\/p>\n Although the program doesn\u2019t replace the amount states are likely to lose, Morgan said it\u2019s still an opportunity to rethink how rural health care is funded. He\u2019d like to see states given flexibility in how they\u2019re able to use the funds, and he hopes they focus on keeping rural communities healthy through preventive care while still helping hospitals keep their doors open.<\/p>\n \u201cIf done correctly, it could really change the future course for rural America,\u201d Morgan said. \u201cThat is such a tough ask, though.\u201d<\/p>\n \t<\/p><\/strong><\/h4>\n Kentucky could take the biggest hit from the new law\u2019s reduction in rural Medicaid funding, losing an estimated $12 billion over 10 years<\/a>, according to a KFF analysis.<\/p>\n Tracking Medicaid patients\u2019 work status may prove difficult for states<\/a><\/p>\n<\/blockquote>\n The state\u2019s Medicaid department is still waiting for additional federal guidance to understand how the state\u2019s program will be affected, Kendra Steele, spokesperson with the Kentucky Cabinet for Health and Family Services, told Stateline in a statement.<\/p>\n \u201cOver 1.4 million Kentuckians rely on Medicaid \u2014 including half of all children in our state, seniors and more vulnerable populations \u2014 and the passage of legislation on the federal level will have serious impacts for those individuals, rural health care and hospitals and local economies,\u201d she wrote.<\/p>\n Even with the new program, states across the country will have to reevaluate their budgets in light of the cuts, said Hemi Tewarson, executive director at the National Academy for State Health Policy, a nonpartisan group that supports states in developing health care policies.<\/p>\n \u201cEvery region is slightly different and there\u2019s not a one-size-fits-all approach,\u201d she said. \u201cHospital ownership varies [as well as] the types of services that are critical for the community where they\u2019re located. They have to think about new ways to provide those services in a context with fewer resources.\u201d<\/p>\n About 44% of rural hospitals are operating in the red<\/a>, according to a KFF analysis of Rand Hospital Data, a higher share than the 35% of hospitals in urban areas.<\/p>\n \t<\/p><\/strong><\/h4>\n Prior to the bill\u2019s passage, Oz attempted to reassure U.S. House Republicans that their districts could get money from the program even if they weren\u2019t specifically rural, Politico reported<\/a> earlier this month.<\/p>\n We\u2019re all rural at heart when it comes to money.<\/p>\n<\/div>\n \u2013 Alan Morgan, CEO of the National Rural Health Association<\/b><\/p>\n<\/div>\n<\/div>\n Pennsylvania Republican <\/span>U.S. Rep. Rob Bresnahan said<\/a> money would begin flowing to his district as early as the beginning of next year, telling the Wilkes-Barre Times Leader earlier this month that he met with Trump, Oz and others to secure pledges that hospitals in his district could access the fund. He represents the northeastern corner of Pennsylvania, which includes suburban and rural areas, as well as the cities of Scranton and Wilkes-Barre.<\/p>\n Though the legislation includes guidelines on which facilities or areas qualify as \u201crural,\u201d Morgan, of the National Rural Health Association, expects a mad dash from lawmakers and providers to claim rural status in order to get a piece of the funding.<\/p>\n \u201cThat\u2019s going to be a huge issue \u2014 defining who\u2019s rural,\u201d Morgan said. \u201cWe\u2019re all rural at heart when it comes to money.\u201d<\/p>\n Stateline<\/a> is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org<\/a>.<\/em><\/p>","protected":false},"excerpt":{"rendered":" A ranch owner brings in a load of hay from her ranch in Texas in 2024. Experts and lawmakers worry a new $50 billion program designed to help struggling rural health care providers may not be enough to offset federal funding losses. (Scott Olson\/Getty Images) Congress set aside $50 billion for rural hospitals and medical…<\/p>\n","protected":false},"author":2,"featured_media":2929,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_kadence_starter_templates_imported_post":false,"_kad_post_transparent":"","_kad_post_title":"","_kad_post_layout":"","_kad_post_sidebar_id":"","_kad_post_content_style":"","_kad_post_vertical_padding":"","_kad_post_feature":"","_kad_post_feature_position":"","_kad_post_header":false,"_kad_post_footer":false,"footnotes":""},"categories":[1],"tags":[],"class_list":["post-2928","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-uncategorized"],"yoast_head":"\n\n
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How it works<\/h4>\n
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Hardest hit<\/h4>\n
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\u2018Rural at heart\u2019<\/h4>\n
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