It's also unclear how much will go to rural areas. The policies and some other factors that states are scored on don't appear to have a rural focus, and some of the permitted uses are not limited to rural areas.

www.kff.org/other-health...

𝐍𝐞𝐰 𝐛𝐫𝐢𝐞𝐟 looking at CMS's funding announcement on the rural health fund.

One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law.

www.kff.org/other-health...

New analysis by @kff.org finds that immigrants make up 3X the share of physicians and surgeons in rural America than their share of the rural population/total workforce (14% vs. 5%). They also play outsized roles in agriculture, construction, and service occupations.
www.kff.org/racial-equit...

The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030.
www.kff.org/medicaid/iss...

CMS just released its 2026 proposed rule for hospital outpatient payments. Among its proposals: lowering reimbursement for drug administration services at hospitals to the physician reimbursement rate.

Check out our brief to learn more about site neutral policies. www.kff.org/medicare/iss...

Medicare DSH = Disproportionate Share Hospital Payments
Medicare UCC = Uncompensated Care Payments

These are two of many ways that Medicare targets funds to hospitals.

Along with Medicaid/ACA cuts, the BBB will trigger mandatory Medicare cuts - about $45B in 2026

If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments)

Historically Congress has stopped triggered cuts before EOY

Within health care, some subsectors are particularly large - ambulatory health care services and hospitals are the 5th and 6th largest employers in the US.

www.kff.org/key-facts-ab...

The Senate added $50B for rural hospitals. While cutting $155B in rural Medicaid spending.

In addition to 17M losing coverage, more people could be affected.

Hospitals are one of the largest employers and may need to layoff workers given cuts to Medicaid, etc. Fewer hospital workers could lead to reduced quality of care or access for everyone. www.kff.org/key-facts-ab...

The Senate's proposed limits on state-directed payments are estimated to lower federal spending by almost $150B over 10 years according to CBO's new estimates, which would likely reduce payments to hospitals and nursing facilities in most states.

www.kff.org/medicaid/iss...

About 2/3 of rural hospital closures occurred in states that did not expand Medicaid between 2014 and 2024.

Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.

The Senate's new reconciliation language would increase some Medicare payments to hospitals in Alaska and Hawaii. Recently, hospitals in Alaska had some of the highest operating margins, in aggregate. Margins in Hawaii were also above the national average.

www.kff.org/health-costs...

One of the biggest flashpoints for the "One Big Beautiful Bill Act" has been its impact on roughly 1800 rural hospitals, which is why Senate Republicans are proposing a new $15 billion rural health fund. However, there are still questions and concerns about the bill 👇 (1/7)

Senate Finance language could lead to cuts in #Medicaid state-directed payments for hospitals and nursing facilities in at least 29 states. See new @kff.org analysis: www.kff.org/medicaid/iss...