Republicans left tribes out of their $50B rural health fund. Now it's up to states to share
The Trump administration is touting its $50 billion Rural Health Transformation Program as the largest-ever U.S. investment in rural health care. But the government made minimal mention of Native American tribes in sparsely populated areas and in need of significant improvements to health care access.
Federally recognized tribes can’t directly apply for a share of the rural health fund — only states can. And states aren’t required to consider tribes’ needs. But state applications for the five-year payout show some states with significant Native American populations did so anyway.
Workforce development, technology upgrades, and traditional healing are a few of the initiatives specifically aimed at Native American communities that some states included in their applications, which were due to the Centers for Medicare & Medicaid Services on Nov. 5. The fund was a late addition to the One Big Beautiful Bill Act in response to worries about the harm the spending reductions in Republicans’ bill would have on rural hospitals’ finances.
Some states, including Idaho, Nevada, and Oregon, are also considering setting aside 3% to 10% of their federal payouts to distribute among tribes. Washington proposed setting aside $20 million per year.
https://washingtonstatestandard.com/2025/12/05/republicans-left-tribes-out-of-their-50b-rural-health-fund-now-its-up-to-states-to-share/
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