Mississippi will receive nearly $206 million in the 2026 fiscal year as a part of a federal program that aims to transform rural health care and offset budget cuts that could harm rural hospitals.
Awards were made to all 50 states as a part of a five-year, $50 billion federal investment into rural health care. The amounts average $200 million and range from $147 million to $281 million. Texas and Alaska will receive the largest shares of funding, while Connecticut and New Jersey were granted the smallest amounts.
“Today marks an extraordinary milestone for rural health in America,” said Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz in a Dec. 29 press release. “Thanks to Congress establishing this investment and President Trump for his leadership, states are stepping forward with bold, creative plans to expand rural access, strengthen their workforces, modernize care, and support the communities that keep our nation running.”
The funding program was tacked on to President Donald Trump’s tax-and-spending law passed this summer, which is expected to result in significant losses to federal Medicaid spending in rural areas. Congressional Republicans added the one-time money for rural health to soften the blow associated with the cuts.
Half of the $50 billion program is to be distributed evenly among all states with approved applications. Awards for the other half of the funding were determined based on a formula that calculated states’ rurality, the quality of its application and implementation of several policies aligned with the White House’s Make America Healthy Again agenda.
Mississippi has recently taken steps to adopt policies that receive higher scores, including reestablishing the Presidential Fitness Test in schools and seeking a waiver to restrict purchases of sugary foods and drinks through the Supplemental Nutrition Assistance Program, or SNAP, in October.
An estimated $137 billion in cuts to federal Medicaid spending are expected in rural areas over 10 years, meaning Rural Health Transformation Program funds will offset roughly a third of those cuts, according to analysis from KFF.
More than half of Mississippi’s rural hospitals are at risk of closing, according to a recent report by the Center for Healthcare Quality and Payment Reform. Hospital leaders have warned that the federal cuts could force more rural hospitals to stop some services or close their doors altogether.
In Mississippi, cuts to state-directed payments, which help hospitals offset low Medicaid payments, will amount to a loss of $160 million a year statewide beginning in 2029, Mississippi Medicaid Director Cindy Bradshaw told lawmakers in September.
The Centers for Medicare and Medicaid Services released application summaries on Dec. 29 submitted by each state.
According to the summary, Mississippi’s plan consists of six initiatives:
A statewide rural health assessment will refine investment strategies and align critical rural health needs with funding after a review of data and stakeholder input.
To improve emergency response, coordination of care after discharge and access to behavioral health services, the coordinated regional integrated systems initiative will integrate emergency medical services, hospitals, public health and social services into regional healthcare districts.
A workforce expansion initiative includes retention awards, residency expansion, preceptor development, early-career outreach and “Earn While You Learn” programs to recruit, retain and train clinicians, allied health professionals and support staff.
The health technology advancement and modernization and telehealth adoption and provider support initiatives will modernize health internet technology and advance telehealth infrastructure, cybersecurity and consumer-facing tools to improve efficiency, coordination and access.
The building rural infrastructure for delivery, growth and efficiency initiative will address capital investments, psychiatric emergency services and care gap closure. It will include pilot programs for early intervention, Autism Spectrum Disorder-focused, care management and value-based care programs, and capital investments will be aimed at expanding facility capacity and specialized services.
No subawardees have yet been awarded as a part of Mississippi’s plan, according to the summary. Agreements will be established when the project is implemented and may be formed with rural hospitals, federally qualified health centers, primary care clinics, community health centers, technology and telehealth vendors, universities and professional associations.
Republican Gov. Tate Reeves, whose office oversaw the development of Mississippi’s plan, unveiled the state’s plan at a Nov. 4 press conference but did not release its application or application summary to the public, like most other states. Mississippi is one of four states that did not publicly release documents pertaining to its plan, and many states released full or partial application documents, according to data from KFF last updated on Dec. 23.
Reeves’ office denied Mississippi Today’s public records request for the application, saying the requested records “appear to be confidential under Federal law” until awards are made, citing the same document that says states may post plans to their websites at their discretion.
It also pointed to a state law that exempts public bodies from the Mississippi Public Records Act’s deadlines during procurement. The law does not bar the state from releasing the records, but says it is not required to meet the usual deadlines until contracts are awarded.
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