In late December, rural hospitals in all 50 states learned how much funding they would receive from the federal Rural Health Transformation Program.
Now, the race is on for hospitals to "submit revised budgets, begin spending, and show the money is going to good use," reports Sarah Jane Tribble, Arielle Zionts and Maia Rosenfeld of KFF Health News. "Federal officials will begin reviewing state progress in late summer and announce 2027 funding levels by the end of October."
The overall RHTP includes $50 billion in federal funds, with $25 billion allocated in different amounts based on a "complicated formula" and the robustness of state applications. For instance, Texas received the largest award at $281 million, while New Jersey received the smallest allotment at $147 million. The initial $25 billion is divided equally among the states.
After state allocations were announced, researchers "began to parse the awards to better understand why some states received more than others, including whether the awards reflected any partisanship or political favoritism," KFF News reports. Although at least one researcher found that higher dollar awards went to Republican states, overall the awards vary "wildly. . . with almost a hundredfold difference between the top and bottom."
State applications consistently included the Trump administration's fitness and nutrition goals, with half promising to "mandate the presidential fitness test," Tribble explains. "Many states also proposed food waivers under the Supplemental Nutrition Assistance Program, known as SNAP, which would limit low-nutrition items such as soda."
Before any RHTP money is spent, states must set up program infrastructure to manage funds and collaborate with rural hospitals. KFF News reports, "Many state legislatures must pass laws to distribute the funding to their state offices. Meanwhile, state officials are hiring staff, organizing advisory committees, and preparing to dole out money."
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