On Point with Meghna Chakrabarti The promise and reality of the rural health fund
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Jan 29, 2026 Keri Cochran-McLean, rural policy leader advocating coverage and payment fixes. Cindy Samuelson, Kansas hospital executive on finances and workforce. Zachary Levinson, health policy analyst on hospital costs. They unpack the $50B Rural Health Transformation Program, why rural hospitals keep losing money, how funds are allocated and limited, and the tough tradeoffs states face between long-term transformation and immediate survival.
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Rural Fund vs. Medicaid Cuts
- The Rural Health Transformation Program gives $50 billion to states but coexists with Medicaid cuts that could remove far more funding from rural care.
- Kaiser estimates rural areas may lose about $137 billion from Medicaid cuts versus $50 billion inflow, revealing a net negative impact.
How The Fund Was Distributed
- Half of the $50 billion was split equally across all states, while the other half used discretionary criteria like rural need and state policy choices.
- The administration tied funds to controversial state policies and used opaque scoring for applications.
Target Investments, Not Shortfalls
- States should invest funds in telehealth, workforce, regional collaboration, and modern tech to transform rural delivery models.
- Avoid using funds for ongoing operational shortfalls since rules limit patient-care spending to 15% of the fund.