States vying for a share of a $50 billion rural health windfall are pledging to advance a slate of Trump administration-backed policy changes, an early sign that an unconventional effort to steer state policy is influencing legislatures nationwide.
The commitments appear in applications filed this month by all 50 states for the new Rural Health Transformation Fund. Congress created the fund to offset losses to hospitals and other providers from an estimated $911 billion in Medicaid cuts included in the One Big Beautiful Bill Act.
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