A $50 Billion Slush Fund Won’t Save Rural Hospitals: Editorial

Aug. 19, 2025, 10:00 AM UTC

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. ...

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