The Rural Health Transformation Program was created under the “One Big Beautiful Bill Act” to distribute $50 billion over five years across all 50 states to strengthen rural health care.
The program to support rural health grew out of concerns that changes to Medicaid under the “One Big Beautiful Bill Act” would undercut already fragile rural health systems.
This week, West Virginia learned that the state has secured $199 million the coming year from the Rural Health Transformation fund.
Yet West Virginia hospitals are anticipated to lose about $1 billion a year in Medicaid funding when the One Big Beautiful Bill legislation is fully implemented.
Jim Kaufman, president of the West Virginia Hospital Association, commended state officials for securing the rural health dollars, saying “This nearly $1 billion investment over five years represents a transformational opportunity to address longstanding challenges in rural healthcare delivery.”
But Kaufman also acknowledged the rural health fund is not the same as the loss of Medicaid dollars after implementation of the Big Beautiful Bill Act.
“While the RHTP program presents a significant opportunity to transform rural healthcare in West Virginia, WVHA will also continue working with Congress to mitigate the pending Medicaid cuts included in the OBBBA,” Kaufman said.
“When fully implemented, these cuts will reduce federal Medicaid funding to West Virginia by more than $1 billion annually.”
Kaufman elaborated on that point during an interview on MetroNews Talkline, highlighting that the average operating margins for rural hospitals are already razor thin.
Kaufman noted that “the Big, Beautiful Bill was a huge package, and this rural health transformation program was added toward the end, after there was a lot of concern about the cuts that the Medicaid program was going to suffer in the package on rural providers, rural hospitals, specifically.
“To give you an idea in West Virginia, once all the provisions in the Big, Beautiful Bill are fully implemented, just West Virginia hospitals will lose more than $1 billion a year in Medicaid cuts. That is a huge impact. So these dollars, while they’re a great opportunity, it is not replacement dollars for what we will see if those cuts are fully implemented.”
The Morrisey administration says West Virginia’s framework under the rural healthcare fund will address:
– The distance between patients and providers.
– The lack of access of rural healthcare providers.
– Resources to support rural healthcare providers.
– Connecting West Virginians to the workforce as they become healthier.
– Preventing adverse health outcomes through nutrition, exercise, and lifestyle changes.
“The $199 million investment for 2026 provides a transformative foundation to improve health outcomes, expand access to care, and strengthen families and communities throughout West Virginia,” Gov. Patrick Morrisey said.
“This award positions our state to deliver better care closer to home and build a healthier future for generations to come. It is also the highest per capita award of any state that West Virginia touches.”
Senator Shelley Moore Capito, R-W.Va., also praised the $200 million set to support rural health in West Virginia next year.
“For rural states like West Virginia, this historic investment is transformative, and it proves that President Trump and Republicans are delivering real results for rural America,” Capito said.
Capito’s statement referred to the Working Families Tax Cut Act, which was the name given to the legislation widely known as the Big Beautiful Bill Act after passage.
“In the crafting of this legislation that impacts every American, I was proud to help shape the Rural Health Transformation Program from the start and to support the Working Families Tax Cuts Act that made this funding possible,” Capito said.
Senator Jim Justice, R-W.Va., described West Virginia’s anticipated portion of the rural healthcare fund as a huge win.
“West Virginia relies on our rural healthcare systems every single day. That’s why I made it a priority to work with my Republican colleagues from day one and secure the funding our state needs,” he said.
With nearly $200 million coming home through the Rural Health Transformation Program, we are making a record-breaking investment towards improving healthcare.”
Many of West Virginia’s health statistics rank near the bottom of the nation, including a 41% obesity rate, diagnosis rates above 15% for adults with diabetes and 14.2% of West Virginia adults reporting a history of heart attack, angina or stroke.
Kaufman said he hopes the rural health fund will help improve health outcomes for West Virginians, potentially reducing the need for care in the first place.
“That’s critical. I mean, if you think about it, you can make a huge impact on your New Year’s resolution, walking more as the governor called for, changing your diet,” Kaufman said.
“That can radically improve diabetes and prediabetes, which then therefore reduces demand for care because we know obesity is tied to so many different healthcare issues.”