By Esteban Fernandez, Times West Virginian
FAIRMONT — On Thursday, Gov. Patrick Morrisey sold the Rural Health Transformation Program as a way to transform the state’s approach to health care.
What was left out of the conversation was the Rural Health Transformation’s original purpose, which was to fund rural hospitals.
“I don’t know about that,” Morrisey said. “It’s designed to help rural health, so there are a lot of beneficiaries from it. Certainly, the hospitals are going to be big beneficiaries, other federally qualified health centers and health care providers.”
Guidance released by the Centers for Medicare and Medicaid Service on the program’s details tell a different story. Page 19 of the program’s federal funding instructions shows states can’t spend more than 15% of funding on payments to health care providers, including rural hospitals.
Moreover, the program’s final form appears to be radically different from what Congress originally envisioned. Senate Finance Committee Chair Mike Crapo, R-Idaho, called the $50 billion health fund the “rural hospital fund,” adding it was the single largest investment in rural health care in more than 20 years. Sen. John Barrasso, another Republican from Wyoming, also called the fund the “rural hospital fund” and Sen. Jerry Moran, R-Kansas, said the money would provide emergency assistance for rural hospitals at risk of closure. Rep. Jule Fedorchak, R-North Dakota, and Sen. Lisa Murkowski, R-Alaska, also supported the bill under the assumption it was for rural hospitals.
Senate Republicans created the Rural Health Transformation Program and threw $50 billion into it as a way to secure passage of President Donald Trump’s Big Beautiful Bill, which cut Medicaid spending by $911 billion over 10 years. The Kaiser Family Foundation, a nonprofit health policy research organization, estimated federal Medicaid spending in rural areas will probably decline by $137 billion over 10 years. West Virginia could lose between $4 billion and $7 billion. Moreover, the $100 million allocated to states for health care spending is only set to last for five years, covering half of the time period the president’s budget bill runs for.
“I think it’s possible there is a gap between what Congress intended when they added the fund and the rules that the Centers for Medicare and Medicaid Services actually put out that establish the parameters,” Kelly Allen, director of the West Virginia Center on Budget and Policy, said. “There’s language in it that said no more than 15% can go to provider payments, which is the big thing that the cuts in the Big Beautiful Bill are impacting. They’re reducing provider payments in a myriad of different ways. So I think the governor’s office is probably making the best out of the rules that CMS gave them to write their application within.”
Photo courtesy of Times West Virginian