The more than 60 million Americans who live in rural areas have poorer health and higher rates of chronic disease than their urban and suburban counterparts.
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In his first inaugural address in 2017, President Donald Trump declared, “Our nation’s forgotten men and women will no longer be forgotten.”
Now, thanks to the President’s Working Families Tax Cuts Act, we are helping make that promise a reality by giving $50 billion to forgotten rural communities in all 50 states under the new Rural Health Transformation (RHT) program.
The more than 60 million Americans who live in rural areas have poorer health and higher rates of chronic disease than their urban and suburban counterparts. For too long, governments have failed to provide urgently needed resources.
For decades, the lobbyists, think tankers, and health system executives who shape our nation’s health care policy have spent as little time as possible in the “Elevated Country” and instead directed resources to the big cities. Meanwhile, rural families are surviving on a patchwork of outdated, understaffed and underfunded health care options.
The RHT Program will address this disparity with once-in-a-generation investments, empowering states to strengthen health care workforce recruitment and retention efforts, train existing workforces, implement new technologies, expand telehealth, empower patients, improve emergency and behavioral care, strengthen partnerships among local health care providers, deploy innovative new payment models, and promote nutrition and exercise programs.
Let’s make America healthier through targeted direct investment.
We’re making America healthy again for all Americans, not just those who live near upscale grocery stores, trendy health clubs, and nationally renowned research hospitals.
A funding opportunity notice posted by the Centers for Medicare and Medicaid Services in September encouraging states to think outside the box with grant proposals did not disappoint.
The state of Alabama has requested funding for a “remote robotic ultrasound” initiative that could be a game-changer for pregnant women in rural areas. Many parents remember gasping in amazement as they watched the little miracle move on the screen, then holding their breath as they waited for the sonographer to tell them if their baby looked fine and healthy.
It’s not just a precious moment. It’s essential health care. But far too many parents in rural America drive long distances for the all-important 20-week anatomical scan, or worse, skip the scan altogether.
The RHT funds we award will allow a pregnant woman in rural Alabama to sit and relax while a trained technician from as far away as Birmingham or Huntsville moves a robotic arm over her belly and points to her baby’s heart, brain, and tiny toes.
The state of Delaware has outlined an ambitious plan to improve the productivity of its local health system by implementing artificial intelligence-powered clinical documentation tools.
Outdated medical records and inefficient management practices are holding back rural health care providers. These restrictions result in physicians spending more time on paperwork and less time treating patients. In the worst-case scenario, people may be thrown into crisis and unable to receive the care they need. Modernizing rural health information technology does more than just save time. It will save lives.
Alaska’s drone medication proposal, Georgia’s effort to install delivery carts in rural emergency rooms with a shortage of obstetrician-gynecologists, Arizona’s establishment of rural medical rotations to address workforce shortages, and Nebraska’s plan to retrofit rural school kitchens to promote healthier food choices and reduce the state’s childhood obesity rates stand out as examples of other cutting-edge projects for rural America that we are funding.
Medicaid spending is not the answer. RHT serves the needs of rural residents.
Every state knows best what its local residents need. Our job is to provide the resources to meet those needs and hold them accountable for delivering results.
Due to partisan politics, critics of the president’s landmark legislation feel forced to argue that the RHT program is a “band-aid on a gunshot wound” and does not offset other cuts in Medicaid spending. They reflexively oppose the common-sense fraud protections, reasonable work requirements, and accountability measures the law put in place to keep Medicaid solvent for future generations.
But high Medicaid spending is not indicative of the health of a local health system.
This is evidenced by the fact that rural areas continue to suffer amid the recent surge in Medicaid costs. One study found that the Obama administration-era Medicaid expansion (90% funded by the federal government) did not result in significant improvements in staffing, operating margins, or quality of care at critical access hospitals, which primarily rural areas rely on.
Even across-the-board increases in Medicaid spending did not solve the rural health care crisis. In fact, the CMS Office of the Actuary estimates that rural hospitals receive only 7% of total hospital spending from Medicaid (approximately $19 billion in 2024).
At this rate, overall Medicaid hospital spending would need to increase by $700 billion over five years just to provide rural health systems with the $50 billion provided by RHT. That is not a wise and efficient way to spend our tax dollars. Physicians would not use a full-body cast to immobilize a broken wrist, and health policy makers should not insist on costly, one-size-fits-all expansions that ignore the unique and immediate needs of rural areas.
Pouring more money into a broken system is not the right solution for rural Americans. They need direct, targeted investments that drive real, sustainable improvement and innovation.
In this way, the Trump Administration is helping America’s forgotten men and women live longer, healthier lives, and that’s exactly what the RHT program provides.
Robert F. Kennedy Jr. is the Secretary of the Department of Health and Human Services, and the Administrator of the Centers for Medicare and Medicaid Services is Dr. Mehmet Oz.
