In Maine, state health officials hoped to steer a slice of $190 million in new federal rural health funding to shield hospitals and clinics from the fallout caused by cuts to federal health programs.
Their plan would have helped pay to treat low-income, uninsured patients.
But federal leaders overseeing the five-year, $50 billion Rural Health Transformation Program said no.
“It was not our decision,” said Lisa Letourneau, a senior adviser at Maine’s health department.
Letourneau told an audience of healthcare providers, advocates, and community groups during a March webinar that the change was “disappointing.”
Maine isn’t alone in having to make changes to plans pitched to win a share of the Trump administration’s new rural health fund.
Centers for Medicare & Medicaid Services Administrator Mehmet Oz praised states’ plans when announcing the rural health program awards last year and said his agency would help states “turn their ideas into lasting improvements for rural families.”
But state officials and healthcare leaders said it’s also clear the agency wants to encourage specific policy changes and hold states accountable to the promises they made and rules they agreed to follow.
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During the past six months, as states raced to meet the program’s looming federal deadlines, CMS staffers worked with state health departments to make a flurry of changes, including scrapping some initiatives. The federal agency has the power to rescind existing funding — or reduce future awards — if states don’t follow rules or meet their goals. “We will take the money back” if states “don’t abide by what they wrote, if they don’t do a good job,” Oz said at an event this month in Washington, D.C.
Congressional Republicans created the Rural Health Transformation Program as a last-minute sweetener in their One Big Beautiful Bill Act last summer. The funding was intended to offset concerns about the outsize fallout anticipate …