One Big Beautiful Bill, One Big Rural Maternity Crisis

Before H.R. 1 passed, rural America was already facing difficulties with access to maternal health care. From hospital closures, workforce shortages, low reimbursement rates, and policy changes, rural maternal healthcare systems have faced a deep crisis that threatens patient access to medical services. 109 rural hospitals have closed since 2005. Between 2024 and early 2026…

September 21, 2026

By

Tanesha Mondestin

and

Georgia Jensen

Blog

New Policy Brief: Rural Communities at Greater Risk of Harmful Impacts from New Medicaid Work Reporting Requirements

As the nation nears full implementation of the Medicaid work reporting requirements Congress enacted in 2025 in H.R. 1, Joan Alker and I took an in-depth look at how these new paperwork requirements to sign-up for and keep Medicaid health coverage will affect residents of rural areas and small towns. Our previous research has shown…

September 14, 2026

By

Adam Searing

Research & Reports

Rural Communities at Greater Risk of Harmful Impacts from New Medicaid Work Reporting Requirements

In 2025, Congress passed H.R. 1, legislation which requires work reporting requirements as a condition of Medicaid eligibility in the 41 states, including Washington, D.C., that have expanded coverage to most low-income adults under the Affordable Care Act. (These mandated reporting requirements also apply in at least two non-expansion states, Wisconsin and Georgia, that cover…

September 14, 2026

By

Adam Searing

and

Joan Alker

Blog

Access to Maternity Care in Rural Areas Likely to Get Worse Due to Medicaid Cuts

As part of CCF’s Rural Health Project, we continue to track the important role Medicaid plays in rural America. A recent research paper on hospitals and maternity care has some important insights, especially for parents in rural areas and small towns. KFF researchers found that 1 in 3 hospitals providing inpatient maternity care to Medicaid…

September 8, 2026

By

Adam Searing

Blog

Post Office Rural Service and Proposed Medicaid Work Reporting Requirements on Collision Course

I recently wrote about problems with the federal government’s suggested definition of “volunteer” in the proposed rule implementing the new law (H.R. 1) passed by Congress that requires patients to meet work/volunteer reporting requirements to maintain Medicaid coverage. The changes in this law are estimated to increase the number of uninsured Americans by 10 million people…

July 6, 2026

By

Adam Searing

Blog

Rural Hospitals and Communities Feeling Impact of H.R. 1 Medicaid Cuts, Rural Health Fund Falls Short

More stories have been published across the country in recent weeks detailing how the federal cuts to health care passed last year by Congress and signed into law by President Trump in H.R. 1, “The One Big Beautiful Bill”, are affecting communities. One emerging theme is that the Rural Health Transformation Fund – a $50…

May 1, 2026

By

Adam Searing

Blog

States are Beginning to Grapple with Federal Medicaid Cuts Impact on Rural Health Care

Over the past week, more national media outlets published articles on the effects of federal cuts to health care passed last year by Congress and signed into law by President Trump in H.R. 1, “The One Big Beautiful Bill.” The coverage shows how states are starting to grapple with the effects of the federal cuts…

March 31, 2026

By

Adam Searing

Blog

Maternal and Infant Health in State Rural Health Transformation Proposals Set Promising Priorities in an Uncertain Landscape

All 50 states applied for CMS’ Rural Health Transformation (RHT) program, a $50 billion fund borne from a need to reassure members of Congress during the final debate over H.R. 1 that Medicaid cuts would not decimate their states’ rural health systems. As previous blogs have detailed, the RHT program presents a unique opportunity for…

March 20, 2026

By

Tanesha Mondestin

and

Nancy Kaneb

Blog

Community Health Workers are a Focus of Rural Health Transformation Applications

Awards for the Rural Health Transformation (RHT) program were released on December 29, 2025, and state applications with proposals for the funds have been made public, covering a range of activities aiming to increase access to care, develop infrastructure, and enhance workforces. As we’ve written about previously, community health workers (CHWs) are a critical workforce…

March 18, 2026

By

Natalie Lawson

and

Adam Searing

Blog

The Rural Health Transformation Fund: Political Rhetoric Meets Bipartisan Concern as the Program Moves Forward

The Trump administration frequently highlights investments in rural health care. While the federal budget bill H.R. 1 (often referred to as the “One Big Beautiful Bill”) passed last year did establish the Rural Health Transformation Fund (RHTF) to inject much-needed capital into rural communities, the same legislation includes deep cuts to the Medicaid program—including billions of dollars…

March 6, 2026

By

Adam Searing

Blog

The Federal Rural Health Transformation Fund: “Likely to Treat Symptoms But Not Deliver a Cure”

The most recent annual analysis on rural health from the health care consulting company Chartis had some interesting insights on rural hospitals, rural health and the federal Rural Health Transformation Fund (RHTF), a part of the H.R. 1 budget bill passed by Congress last year. While the entire report is worth a read, here are some…

February 25, 2026

By

Adam Searing

Blog

Fact-Checking Dr Oz’ Claims About Rural Health Investments

CMS Administrator Mehmet Oz makes two statements in this short video that are not correct: Rural areas and small towns need assistance with health care affordability, quality and accessibility. The Rural Health Transformation Fund, despite its origin as a political maneuver to enable passage of the 2025 federal budget reconciliation law (HR1), means substantial help…

February 6, 2026

By

Adam Searing

Blog

Trump Administration Severely Limits Rural Health Transformation Funds for Rural Hospitals and Clinics – Capped at 15%

Passage of the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid and CHIP spending over 10 years and an increase in the number of uninsured Americans of 10 million. These are the largest health cuts in Medicaid’s history, and passage of…

October 21, 2025

By

Adam Searing

Blog

How Can the Rural Health Transformation Fund Help Make Maternal Health Great Again?

The passing of the HR.1 bill has threatened the vitality of rural health in America. To soften the blow, the Trump administration included a $50 billion Rural Health Transformation Fund (RHTF). States are preparing their applications that are due on November 5th. There is a lot to unpack with the RHTF. My colleague Adam Searing…

October 9, 2025

By

Tanesha Mondestin

Blog

States Should Use Rural Transformation Fund to Focus on Children and Families

At this moment, states are seeking input and putting ideas on paper to develop priorities for their state applications for a piece of the $50 billion Rural Health Transformation Fund included in H.R. 1 (with applications due to the federal government by November 5th). Our colleague Adam Searing reminded readers that these funds will by…

September 26, 2025

By

Elisabeth Wright Burak

and

Anne Dwyer

Blog

Unpacking the Rural Health Transformation Fund Created by Congress to Soften Impact of Medicaid Cuts on Rural Hospitals

I grew up in North Carolina and often split my time between the urban center of the state and some of its most beautiful and rural areas on the back sounds “Down East.” This part of NC is so rural and was isolated for so long, generations of residents still speak with a distinctive Elizabethan…

September 19, 2025

By

Adam Searing

Blog

Untangling the Current Debate Around Federal Medicaid Cuts, the “Rural Health Transformation Program” and State Medicaid Budgets

The Congressional Budget Office estimates that the budget reconciliation law signed into law by President Trump (HR1) will result in a gross reduction of $990 billion in federal Medicaid/CHIP spending over 10 years and an increase in the number of uninsured Americans by 10 million. This is the largest cut to Medicaid in the history…

September 2, 2025

By

Adam Searing

Blog

States’ Maternal Mental Health Efforts Show Improvement as Need for Support Grows, Especially in Rural Areas

The Policy Center for Maternal Mental Health recently released state-by-state maternal mental health report cards that provide a snapshot of state progress addressing maternal mental health. Using measures across three domains—providers and programs, screening, and coverage—these report cards pinpoint areas of opportunity for states to improve maternal mental health. Overall, the report shows modest progress…

July 14, 2025

By

Tanesha Mondestin

Presentations

Webinar and Report Release: Medicaid Key to Maternal and Infant Health in Rural America

Georgetown University CCF shared a new report with state-by-state data on Medicaid coverage of women of reproductive age and how cuts could impact their access to obstetric care in small towns and rural areas. Medicaid plays a larger role in providing health coverage to people living in small towns and rural communities than it does…

May 19, 2025

Research & Reports

Medicaid Plays A Key Role for Maternal and Infant Health in Rural Communities

Key Findings: Introduction This paper examines the role of Medicaid in covering women of childbearing age (19 through 44 years old) living in small towns and rural areas. Previous research in this series found a higher reliance on Medicaid as a coverage source for children and all non-elderly adults living in small towns and rural…

May 15, 2025

By

Joan Alker

and

Aubrianna Osorio

Search

Filter By

Date

Results