RFK Jr. & Dr. Oz boast about slashing $87 billion in rural healthcare

(sigh) So, moments ago I received the following press release from the Centers for Medicare & Medicaid Services (CMS):

Today, the Centers for Medicare & Medicaid Services (CMS) unveiled details on how states can apply to receive funding from the $50 billion Rural Health Transformation Program created under the Working Families Tax Cuts Act to strengthen health care across rural America. This unprecedented investment is designed to empower states to transform the existing rural health care infrastructure and build sustainable health care systems that expand access, enhance quality of care, and improve outcomes for patients.

Amusingly (and sadly), the link itself goes to the WhiteHouse.Gov page describing not the "Working Families Tax Cuts Act" (which doesn't exist) but rather the so-called "One Big Beautiful Bill Act" which is what Trump and Republicans insisted on calling it for months, right up until they realized that it's about as popular as a turd in a punchbowl, at which point they decided that simply rebranding it as a "tax cut" for "working families" will solve all their problems at the midterms next year.

“Rural communities are the bedrock of America. They have waited too long for Washington to act. Now, at last, we are acting with the largest investment ever made to improve health care for rural Americans,” said U.S. Health and Human Services Secretary Robert F. Kennedy, Jr. “This $50 billion program is about delivering dignity and dependable care to rural communities, making sure every American has access to affordable, high-quality treatment.”

“This program is a historic investment that will catalyze needed change in rural health systems and improve lives for generations to come,” said CMS Administrator Dr. Mehmet Oz. “For too long, when it comes to health care access and infrastructure, we've left behind the backbone of America. That stops now with this program that will spark real change for rural health care.”

The only problem with making an "unprecedented $50 billion investment" in rural health is that it was hastily thrown into the bill at the last minute by Senate Republicans in order to get people to stop complaining about the $137 billion in cuts to Medicaid in rural areas of the country:

...In rural communities, Medicaid covers nearly half of all births and one fifth of inpatient discharges. The Congressional Budget Office (CBO) estimates that the enacted reconciliation package would reduce federal Medicaid spending by an estimated $911 billion over ten years, and result in 10 million more uninsured people nationwide.

...To address those concerns, the reconciliation package includes $50 billion in funding over five years (starting in fiscal year 2026) for state grants through a Rural Health Transformation Program (referred to here as the “rural health fund”).

...Under the reconciliation package, federal Medicaid spending in rural areas is estimated to decline by $137 billion, more than the $50 billion appropriated for the rural health fund (Figure 1). Building on separate KFF estimates of state-by-state Medicaid cuts, this analysis estimates that federal Medicaid spending in rural areas could decrease by $137 billion over 10 years—about $87 billion more than is appropriated for the rural health fund.

As far as I can tell, the net result of this will be that rural hospitals will be able to pay to keep the lights on while remaining empty since all their patients will have been kicked off of Medicaid. Yay team?

Furthermore, even the $50 billion itself is being described as a "slush fund" with no clear idea of how the money will actually be allocated:

The Trump administration on Monday kicked off a scramble among the 50 states for a slice of a new $50 billion fund for rural health care, but experts on the ground fear the program’s rushed timeline, lack of guardrails and potential for politicization will leave some hospitals struggling to stay open.

...Monday’s announcement kicks off a “Hunger Games"-like competition for the federal funds, but health industry leaders in states desperate to shore up their crumbling rural health systems remain skeptical about where the money will ultimately go.

...half of the fund will be dispensed at the discretion of Oz, while the other half will be divided equally among states that apply — meaning Wyoming would get the same amount as California despite their massive population difference. How much states get will also depend on whether they implement policies pushed by the Trump administration...

States have no ability to appeal if their applications are rejected or they receive less money than they requested. Oz also said the federal government can “claw back” funding from states that “don’t perform” and redistribute it."

In other words...a slush fund.