Republicans’ “Big, Beautiful Bill” might not have passed absent an 11th-hour provision. Worried that cutting almost $1 trillion from Medicaid might hurt rural hospitals, some lawmakers demanded a special subsidy to keep them afloat.
What resulted was something of a slush fund. The “rural hospital transformation program” allocates $50 billion toward state grants. Its requirements to participate are broad, to say the least. Half the funds will be given to states that submit a plan to “transform” rural health care. The rest will be disbursed at the administration’s discretion. Perplexingly, there’s no requirement that grants actually go to rural hospitals.