The Trump administration on Monday kicked off a scramble among the 50 states for a slice of a new $50 billion fund for rural health care, but experts on the ground fear the program’s rushed timeline, lack of guardrails and potential for politicization will leave some hospitals struggling to stay open.
States have just a few weeks to submit detailed applications for the fund, which Congress created
late in its negotiations over a bill this summer that made deep cuts to Medicaid and other health programs. Federal health officials will then have a couple months to review them and dispense the money.
After the application window closes in early November, half of the fund will be dispensed at the discretion of Oz, while the other half will be divided equally among states that apply — meaning Wyoming would get the same amount as California despite their massive population difference. How much states get will also depend on whether they implement policies pushed by the Trump administration
States will
have no ability to appeal if their applications are rejected or they receive less money than they requested. Oz also said the federal government can “claw back” funding from states that “don’t perform” and redistribute it, saying: “This is not punitive. This is a very clever decision by the crafters of the law.”
Even if all the money goes to where it’s needed most, many experts are concerned that it will not make up for the massive hit rural providers are expected to take from the other provisions of the bill, including the reduction of hundreds of billions of dollars in Medicaid.