In November, state leaders unveiled ideas for using their share of a substantial $50 billion federal rural health program. Proposals included setting up medication-delivering drones and offering telehealth services at local libraries.
The Trump administration has promised “radical transparency” regarding the program, stating they will publish project summaries for states that receive funds. However, many states are still keeping their complete applications under wraps, which concerns health experts.
Alan Morgan, CEO of the National Rural Health Association, emphasized the need for transparency. “Community leaders want to know what their states are doing,” he said. Rural hospitals and clinics face significant challenges, and this program aims to help them but requires clear communication.
The program, established through the One Big Beautiful Bill Act, aims to boost rural healthcare while imposing cuts on Medicaid, which many rural providers heavily rely on. Half of the $50 billion will be evenly distributed among states with approved applications, while the remaining funds will be allocated based on a points-based system tied to various initiatives.
Secretary of Health and Human Services, Robert F. Kennedy Jr., has sought to assure the public about the government’s commitment to transparency. Yet, experts like Lawrence Gostin from Georgetown University argue that without proper transparency, it’s hard for the public to hold agencies accountable.
Concerns about political bias in funding decisions have surfaced. For instance, Rep. Nikki Budzinski (D-Ill.) expressed worries that her state’s application might not be considered fairly due to its Democratic leadership.
On a positive note, Heather Howard from Princeton University noted that many states are openly sharing their project summaries, indicating strong interest in the program. Preliminary findings reveal trends, such as a push for home-based services, technology use, and workforce development. Exciting initiatives include remote ultrasounds using robots, which were proposed in Georgia and Alabama.
All 50 states submitted their applications by the November 5 deadline, and awards are expected by the end of the year. Notably, about 40 states have already shared their project narratives, while a few states like Idaho and Iowa released their complete applications.
Despite this enthusiasm, some states, including Nebraska and Kentucky, are withholding certain application materials, citing various reasons, from proprietary information to being in draft form. This reluctance raises questions about transparency in the process.
As noted in a recent Commonwealth Fund report, rural areas still struggle with access to primary care. The guidelines for the new program restrict states to using only 15% of their funds for direct patient care, complicating the support for rural facilities that already operate on tight budgets.
Celli Horstman, a researcher, highlighted the potential effects of both funding cuts and this new program. There seems to be a mixed response among states, with some willing to adopt certain administration goals while passing on others. Proposals vary widely, like Arkansas’ innovative “FAITH” program aimed at leveraging local religious institutions or Alaska considering drone systems for remote medication delivery.
State Sen. Stephen Meredith from Kentucky expressed skepticism about the program’s effectiveness, stating, “We’re treating symptoms without curing the disease.” Similarly, Morgan cautioned that while plans may appear promising, translating them into functioning programs is a complex task.
Amid these discussions, public interest and scrutiny will be critical as states navigate the intricate landscape of rural healthcare funding. The upcoming announcements will surely reveal which states’ proposals resonate best with federal goals and the challenges that lie ahead for rural health systems.
For more details on this topic, you can visit KFF Health News.
