Senator Jimmy Hickey, Jr. Column
Recently, the state Senate and House Committees on Public Health, Welfare, and Labor met jointly to review major developments affecting rural health care in Arkansas. The Senate committee is chaired by Senator Missy Irvin, with Senator Dave Wallace serving as Vice Chair.
Committee members heard an overview of the Rural Health Transformation Program from the Arkansas Department of Finance and Administration.
On July 4, 2025, President Donald Trump signed H.R. 1 into law, making significant changes to federal spending and tax policy. Some of these changes affect funding for Medicare, Medicaid, and other health coverage programs. Rural health systems, which rely heavily on public insurance programs, will feel these impacts more than urban areas. To help address this, Congress created the Rural Health Transformation Program. It provides $50 billion over five years for states to help soften the impact of federal funding reductions on rural communities.
The new law shifts more responsibility for supporting health care from the federal government to states and local communities. Because of this, it is important for rural leaders to understand their communities’ health needs and work together across regions to make the best use of available resources.
Arkansas will be especially affected by these changes. Nearly 45 percent of Arkansans live in rural areas, where residents often have less access to care, more challenging health outcomes, and more fragile healthcare systems. Half of the state’s rural hospitals are considered at risk of closure, which is the highest rate in the country. This makes it critical to use Arkansas’s Rural Health Transformation funds to strengthen the long-term stability of rural healthcare providers. The program offers a chance to improve rural healthcare infrastructure, expand collaboration, and reduce the gap in access and quality between rural and urban areas.
The state’s Rural Health Plan sets a vision for redesigning rural health care around prevention, connectivity, and sustainability, rather than only keeping facilities open. The plan links healthcare improvements to broader goals such as healthier children, stronger families, a more stable workforce, and stronger local economies. Potential applicants are encouraged to view the program as a multi-year effort to transform operations, not as a one-time grant opportunity.
Funding may be used for projects such as workforce recruitment and training, leadership development, expanding services, redesigning care models, telehealth and health IT upgrades, care coordination, and planning for long-term sustainability.
Funds may not be used to pay off debt, cover operating losses, perform routine maintenance, replace capital equipment, replace existing funding sources, or make one-time purchases that cannot be sustained.
The Rural Health Transformation Program will distribute $50 billion to participating states from 2026 through 2030, with $10 billion available each year. In December 2025, the Centers for Medicare and Medicaid Services announced the first round of awards, including $208,779,396 for Arkansas. Additional awards will be announced in later rounds.
On May 4, Governor Sarah Huckabee Sanders announced the initial funding application process is underway. You can get details at www.ArkansasRHTP.com.