Laurie Buckhout Touted The Rural Health Transformation Program In The Big Beautiful Bill That Fell Far Short Of North Carolina’s $50 Billion Medicaid Funding Loss Originally Caused By The Bill
The One Big Beautiful Bill Included A $50 Billion Fund For Rural Health Care And Directed $213 Million To North Carolina For 2026
The One Big Beautiful Bill Included A $50 Billion “Rural Health Transformation Program” That Represented Just 37% Of The Estimated Loss Of Federal Medicaid Funding In Rural Areas
Republicans Included A $50 Billion Fund For The “Rural Health Transformation Program” After Cutting Medicaid By Over $900 Billion Over 10 Years. “On July 4, 2025, President Trump signed a budget reconciliation bill into law that includes significant reductions in federal health care spending, large tax cuts, and other changes. The new law will reduce federal Medicaid spending alone by $911 billion over ten years and lead to 10 million more people becoming uninsured by 2034 based on Congressional Budget Office (CBO) estimates. While this legislation was being debated, Members of Congress from both parties raised concerns about the potential impact on rural hospitals, particularly given the ongoing trend of rural hospital closures. In response, and just prior to passage, the Senate added $50 billion in funding for a new ‘rural health transformation program,’ referred to here as the ‘rural health fund.’” [KFF, 8/4/25]
KFF: The $50 Billion Fund Represented Just 37% Of The Estimated Loss Of Federal Medicaid Funding In Rural Areas, Or 5% Of The Total Federal Medicaid Cuts Nationwide. “The $50 billion in new funding could offset a little over a third (37%) of the estimated cuts to federal Medicaid spending in rural areas ($137 billion over ten years) based on KFF analysis of CBO’s estimates, or about 5% of the total estimated cuts to federal Medicaid spending ($911 billion over ten years). This does not account for other revenue losses related to the bill, including cuts to federal spending for the ACA Marketplaces, or the revenue losses stemming from the increased number of people who will be uninsured because of the expiration of the enhanced ACA premium tax credits and the implementation of final Marketplace integrity rules. The impact of these changes on rural areas, and the extent to which the rural health fund offsets losses, will vary across the country.” [KFF, 8/4/25]
The Trump Administration Awarded North Carolina $213 Million From The Rural Health Care Fund For 2026
January 2026: The Federal Government Awarded North Carolina $213 Million To Support Rural Hospitals. “The federal government has awarded $213 million to North Carolina to help support rural health care. The funding backed by Congressman Chuck Edwards comes from the Rural Health Transformation Program. ‘The program has worked exactly like we intended for it to work. We've got a lot of work yet to do to improve our healthcare system in America,’ Edwards said.” [ABC 13, 1/4/26]
CMS Announced The Rural Health Transformation Program Would Provide Funding For Five Years From FY 2026 Through FY 2030. “RHT Program funding is $50 billion to be allocated to approved States over five fiscal years, with $10 billion of funding available each fiscal year, beginning in fiscal year 2026 and ending in fiscal year 2030. 50% to be distributed equally amongst all approved States 50% will be allocated by CMS based on a variety of factors including rural population, the proportion of rural health facilities in the State, the situation of certain hospitals in the State, and other factors to be specified by CMS in the NOFO.” [Centers for Medicare & Medicaid Services, accessed 1/6/26]
Buckhout Said The Solution To Rural Hospitals’ Struggle Was The Rural Health Funding Included In The Big Beautiful Bill
VIDEO: Buckhout Said The Solution To Rural Hospitals’ Struggle Was The Rural Health Funding Included In The Big Beautiful Bill. “For starters, I've been all over this district, and there are counties in this district that are among the poorest in the United States. They don't have access to health care. Hospitals have been closed. They don't have access to emergency facilities, and I see that a lot of because there's not a tax base, there are not jobs, and people are truly suffering. We have to access the Rural Health Care associations put forth in the big, beautiful bill so we can help folks living in those communities. We have to push health care down and what you have to have is an active representative in Congress who's willing to fight for that. You haven't had that here in North Carolina, in the in the first congressional district, for decades. Nobody's been pushing funding down here. Nobody's been pushing jobs down here to create a tax base, which in turn is going to create better health facilities, better education facilities, better recreation facilities, etc. You got to have a fighter ready to bring those funds down and help open up rural health care opportunities. We need them desperately.” [WNCT NC-01 GOP Candidate Debate, 13:38, 2/19/26] (VIDEO)
The One Big Beautiful Bill Was Slated To Cost North Carolina $50 Billion In Medicaid Funding
NC Department Of Health And Human Services: North Carolina Would Lose $50 Billion Over Ten Years From The Big Beautiful Bill
NCDHHS: North Carolina Was Projected To Lose $50 Billion In Medicaid Funding, Which Would Disproportionately Affect Rural North Carolinians. “The North Carolina Department of Health and Human Services announced today it will begin preparing to submit its application to receive funding from the Rural Health Transformation Program (RHTP). The program is part of H.R. 1, a federal bill signed into law by President Trump in July to address rural health concerns due to federal cuts to the Medicaid program. NCDHHS has created a website with a link for providers to give feedback now on what should be considered for North Carolina’s application and will host several opportunities for partner organizations to provide input for the state’s RHTP application in the coming months. The Medicaid program will see cuts resulting in approximately $1 trillion in losses nationwide in the next 10 years due to H.R. 1, including $49.9 billion in North Carolina, and these cuts will disproportionately impact people who live in rural communities. NCDHHS works to create a healthier state for everyone who calls this state home, including the more than 3 million people in rural North Carolina.” [NCDHHS, 8/14/25]
Mountain Area Health Education Center CEO William Hathaway Said Medicaid Cuts Weakened Rural Hospitals’ Finances. “While the One Big Beautiful Bill or H.R. 1 helped approve this funding initiative, that same law also created stricter eligibility requirements for Medicaid, which could impact finances for rural hospitals. ‘They're critically dependent on Medicaid and federal dollars to stay afloat. So when you cut those services for the hospitals specifically, there's great risk to their financial viability,’ said William Hathaway, the CEO of Mountain Area Health Education Center (MAHEC).” [ABC 13, 1/4/26]
Hathaway Said The Big Beautiful Bill’s Rural Health Funds Were Appreciated, But They Did Not Come Close To Recouping The $50 Billion North Carolina Hospitals Were Losing From The Big Beautiful Bill. “These stricter eligibility requirements are not the only concern because the One Big Beautiful Bill also includes significant cuts to Medicaid funding. Hathaway says that while MAHEC is excited about the opportunity of this program, it does not come close to offsetting the loss in Medicaid dollars. ‘This will be $200 million a year for five years. So a total of a billion dollars to the state of North Carolina at a time when over the next 10 years we will see a loss of $50 billion from the federal government in Medicaid funding,’ Hathaway said.” [ABC 13, 1/4/26]
Hathaway: “So A Total Of A Billion Dollars To The State Of North Carolina At A Time When Over The Next 10 Years We Will See A Loss Of $50 Billion From The Federal Government In Medicaid Funding.” “These stricter eligibility requirements are not the only concern because the One Big Beautiful Bill also includes significant cuts to Medicaid funding. Hathaway says that while MAHEC is excited about the opportunity of this program, it does not come close to offsetting the loss in Medicaid dollars. ‘This will be $200 million a year for five years. So a total of a billion dollars to the state of North Carolina at a time when over the next 10 years we will see a loss of $50 billion from the federal government in Medicaid funding,’ Hathaway said.” [ABC 13, 1/4/26]