Rfk Jr. Misses Mark In Touting Rural Health Transformation Fund As Historic Infusion Of Cash

At a September Senate hearing, Health and Human Services Secretary Robert F. Kennedy Jr. boasted astir a agrarian wellness inaugural wrong President Donald Trump's "One Big Beautiful Bill Act.”

"It’s going to beryllium nan biggest infusion of national dollars into agrarian wellness attraction successful American history," Kennedy said, responding to disapproval from Sen. Bernie Sanders (I-Vt.). Sanders said nan rule would harm patients and agrarian hospitals.

Kennedy was referring to nan law's five-year, $50 cardinal Rural Health Transformation Program, HHS spokesperson Emily Hilliard said. GOP lawmakers person made akin claims astir nan program.

The money was added to nan measure astatine nan past infinitesimal to unafraid support from Republican lawmakers who correspond agrarian states. Some were concerned astir really nan bill's Medicaid cuts would harm agrarian America, wherever much than 150 hospitals person stopped offering inpatient services aliases been shuttered wholly since 2010, according to nan Cecil G. Sheps Center for Health Services Research astatine nan University of North Carolina.

"The translator money was really talked astir successful nan discourse of redeeming agrarian hospitals that would beryllium facing these important Medicaid cuts," said Carrie Cochran-McClain, main argumentation serviceman astatine nan National Rural Health Association. Medicaid is nan associated state-federal wellness security programme that chiefly covers low-income group and those pinch disabilities.

So is Kennedy correct successful his explanation of nan agrarian wellness money arsenic a historical rate infusion, aliases does it neglect to admit captious context?

The Rural Health Transformation Program

Trump's taxation and spending rule is expected to trim national Medicaid spending successful agrarian areas by astatine slightest $137 cardinal by 2034, according to an study by KFF, a wellness accusation nonprofit that includes KFF Health News. The Congressional Budget Office predicts nan rule will summation nan wide number of uninsured patients by 10 cardinal by 2034.

Rural wellness accommodation disproportionately trust connected Medicaid reimbursement to enactment afloat. In 2023, 40.6% of children and 18.3% of adults nether property 65 from agrarian areas and mini towns were enrolled successful Medicaid, according to nan Center for Children and Families astatine Georgetown University. In metro areas, nan rates were 38.2% and 16.3%, respectively.

The Trump management argues that agrarian hospitals cannot trust connected "legacy" backing sources for illustration Medicaid and Medicare owed to nan programs’ reimbursement structure, which ties payments to nan number of services provided, a exemplary that's not financially sustainable for agrarian accommodation pinch typically debased diligent volumes.

"Distinct from these different programs, nan Rural Health Transformation Program is designed to supply a elastic root of investment" to beforehand innovation, efficiency, and sustainability, nan White House wrote successful a memo.

Here's really it works. States tin propose projects spearheaded by authorities agencies, wellness attraction providers, consultants, and vendors aimed astatine various purposes, specified arsenic improving technology, entree to care, and workforce recruitment.

States tin usage only 15% of their translator programme backing for supplier payments and tin nonstop money to non-rural areas, according to KFF.

Half of nan $50 cardinal will beryllium evenly divided among states whose applications are approved — sloppy of their agrarian and wide populations — according to nan "Notice of Funding Opportunity" for nan program.

The different half will beryllium awarded based connected "the transformative possibilities" of states' assistance proposals; really overmuch they've committed to aligning their wellness policies pinch nan Trump administration's; and information connected their agrarian population, agrarian wellness facilities, uncompensated care, and different measurements.

The exertion deadline is Nov. 5.

The large picture

Michael Meit, head of nan Center for Rural Health and Research astatine East Tennessee State University, said nan agrarian wellness organization is excited astir nan innovations nan caller programme mightiness foster, but he'd "love for it to hap successful nan absence of these cuts that are going to devastate our agrarian wellness system."

"It's not going to capable nan hole," Meit said.

KFF estimates that nan agrarian wellness fund's five-year, $50 cardinal finance is simply a small complete a 3rd of nan expected nonaccomplishment of national backing successful agrarian areas that will beryllium dispersed complete 10 years. According to that analysis, Medicaid cuts complete that play would tally astatine slightest $137 cardinal successful agrarian areas.

That number doesn't account for different reductions stemming from nan aforesaid law, specified arsenic cuts to nan ACA Marketplaces aliases nan wellness strategy gross nonaccomplishment expected from an summation successful nan number of group without insurance. 

These factors are important to statement because nan agrarian wellness programme is simply a impermanent initiative, while reductions successful national spending are long-term. 

Another rumor is nan quality successful nan program's spirit. The agrarian wellness money is focused connected transforming nan agrarian wellness attraction strategy — not providing continued backing to support accommodation unfastened aliases making up for mislaid Medicaid funds. Even if nan money triggers successful innovations, location are doubts that those will hap successful clip to forestall agrarian wellness accommodation from closing.

"There’s a existent misperception that someway these costs are going to beryllium capable to prevention agrarian America aliases prevention agrarian hospitals," Cochran-McClain said.

Joseph Antos, a wellness argumentation master and elder chap emeritus astatine nan conservative-leaning American Enterprise Institute, said Kennedy's remark is thing "politicians opportunity erstwhile they want to disregard nan remainder of nan policies."

"What they wanted was to opportunity that they were creating a caller program," Antos said. "Well, this is simply a very inefficient measurement to administer a comparatively very mini magnitude of money to hospitals that will incur overmuch larger bad indebtedness complete nan coming years, acknowledgment to nan cuts successful Medicaid.”

One caveat

Experts said that erstwhile viewed extracurricular of mandatory programs for illustration Medicare and Medicaid, nan $50 cardinal agrarian wellness money does look to beryllium unrivaled, particularly for a limited, five-year program.

Several mentioned nan Hill-Burton Act arsenic different programme that importantly boosted agrarian wellness care. The rule provided loans and grants that modernized aliases built 6,800 wellness facilities, galore of which were successful agrarian areas, from 1946 to 1997, according to nan Health Resources and Services Administration.

Incomplete backing information makes it difficult to relationship for inflation, said Kelsey Moran, an adjunct professor and wellness economist astatine nan University of Miami.

But she estimated that, during nan life of nan program, it spent $47 cardinal successful 2024 dollars erstwhile utilizing nan Consumer Price Index, aliases $109 cardinal erstwhile utilizing nan CPI's aesculapian attraction index. The aesculapian scale has a higher ostentation complaint because wellness prices person risen much than wide prices.

Our ruling 

Kennedy said nan agrarian wellness money is "going to beryllium nan biggest infusion of national dollars into agrarian wellness attraction successful American history."

The connection contains an constituent of truth because nan caller programme could beryllium nan astir important one-time finance successful agrarian wellness funding.

But it ignores captious facts and discourse that create a different impression.

Federal contributions to agrarian areas from Medicaid and Medicare easy dwarf this program's $50 cardinal mark. The caller money offers states elasticity successful really they tin allocate resources, meaning there's nary guarantee that each nan caller backing will spell to agrarian Americans' wellness care. The programme comes astatine nan aforesaid clip agrarian areas are expected to suffer acold much from Medicaid cuts and an summation successful uninsured patients than what nan agrarian wellness money infusion tin backfill.

Experts opportunity nan agrarian wellness fund's rate infusion is canceled retired by different parts of Trump's taxation and spending rule that telephone for cuts and argumentation changes.

We complaint this connection Mostly False.