US lawmakers propose measures to protect rural hospital funding

Members of the US Congress from both parties are introducing legislation to mitigate the impact of upcoming funding cuts to rural hospitals. These cuts, stemming from the “One Big Beautiful Bill” passed in July 2025, are expected to affect Medicaid, the Affordable Care Act marketplaces, and the Supplemental Nutrition Assistance Program, with an estimated total reduction of $1.3 trillion.

While the 2025 law established a $50 billion Rural Health Transformation Program over ten years, officials note these funds are designated for innovation rather than offsetting direct operational losses. Lawmakers are currently proposing solutions such as interest-free loans for equipment upgrades and addressing Medicaid and Medicare reimbursement issues.

Representative Jill Tokuda (D-Hawaii), co-chair of the House Rural Health Caucus, warned that new work requirements within the law could lead to patients losing coverage due to administrative hurdles. She noted that rural hospitals often absorb the costs of treating uninsured patients, which threatens the stability of facilities already operating on thin margins.