Experts warn that bipartisan legislation meant to counter Medicaid cuts won't do enough to offset the loses

The $50 billion fund created in 2025 to counter Medicaid cuts from the One Big Beautiful bill (OBB) will not be enough to save rural hospitals or "prevent the overwhelming health care harms" caused by the bill, writes Dustin Pugel of the Kentucky Center for Economic Policy. In fact, the Rural Health Transformation Program (RHTP) was "never intended to be a replacement for lost Medicaid funds." 

For example: Pugel writes that Kentucky’s 2026 RHTP award is $212.9 million, but "the estimated cuts to Kentucky’s Medicaid program in rural areas is $10.9 billion over the next decade." So, even if Kentucky gets the same amount of RHTP funds every year for five years, "funding from that project will make up for less than 10% of the cut to Medicaid in rural Kentucky," Pugel writes. 

Pugel writes that rural hospitals are disproportionately affected by the policy changes, and most of the RHTP initiatives can't be used to help them. Liz Carey of The Daily Yonder, though, reports that several "Congress members from all over the country, and from both parties, have introduced legislation aimed at helping rural hospitals" in addition to the RHTP. 

One such effort is the Rural Health Agenda, a package of bills being advanced by Tennessee Republican Sen. Marsha Blackburn. The Rural Health Agenda includes at least four pieces of legislation that would help support rural hospitals through reimbursement and Medicare changes, and create a new loan program through the USDA.