Kimberly Adams

Last summer, when negotiations were playing out over the GOP's big tax and spending bill, you'll know it and love it, is the one big beautiful bill act.

States and health care advocates raised alarm over the roughly one trillion dollars in cuts to Medicaid that were in the legislation.

Now, even though that total is over 10 years, according to the Congressional Budget Office, that's still a huge hit.

And early data are showing that those cuts are going to hit particularly hard in rural communities.

So in response to that, Congress pulled together a $50 billion pot of money for rural health care that's going out over the next five years.

It's called the Rural Health Transformation Program.

And that made it into the final version of the bill.

And some of that $50 billion in funding is finally starting to roll out.

So to help make us smart about this, we are joined by Arielle Zients.

She's a rural health care correspondent for KFF Health News and based in South Dakota.

Arielle, welcome to the show.

Arielle, first walk us through how the Rural Health Transformation Program works.

What determined how much money states were going to get, whether it be $100 million this year or $200 million or something in between?

That's really interesting, this aligning with the Make America Healthy Again movement, because there are some health care advocates that have raised concerns about some of these rules around the program and this political alignment.

I mean, what kind of things are in that part of the criteria?

I mentioned at the top that, you know, the One Big Beautiful Bill Act included something close to a trillion dollars in cuts, according to the CBO.

With those cuts in mind, how much of a difference can this rural health transformation funding really make?

Right.

You mentioned earlier that some of the money in this rural transformation program is going to grants and that, you know, imagine different groups are putting in, you know, requests for some of those grants.

What kind of projects look like they're going to make it through?