Rural communities have been navigating serious health challenges for a long time—hospital closures, workforce shortages, long drives to see a specialist, and higher rates of chronic disease, to name just a few. These issues are deeply connected, and for many communities, they’ve reached a breaking point.
Congress aimed to address these challenges by creating the Rural Health Transformation (RHT) Fund, part of the One Big Beautiful Bill Act (HR1) passed last July. The RHT Fund represents an important federal investment—designed not just to keep rural health systems afloat, but to help them evolve into models that are more stable, preventive, and community‑centered over the long term. And at the same time, while the RHT Fund is key in strengthening rural health access, with the level of Medicaid funding cuts overall including in HR1, resources will continue to be a challenge more broadly. And because the funding for the RHT Fund is for five years, sustainability also needs to be further considered as this work moves forward.
Now that states are moving from planning into implementation, the RHT Fund is starting to shape how rural health care is financed, organized, and delivered. While states receive the funding directly, nonprofits and community‑based organizations are essential partners in turning system‑level investments into real improvements in people’s lives.
If your organization works in or alongside rural communities, understanding how the RHT Fund works—and how your state is approaching it—is becoming increasingly important. To further inform how the Lutheran Services in America network can leverage the RHT Fund, read: The Rural Health Transformation Fund: What It Is, How States are Using It, and Where Nonprofits Fit In.
Shao-Chee Sim is Executive Vice President for Health Policy, Research, and Strategic Partnerships at Episcopal Health Foundation and Sue Polis is Vice President of Public Relations and Government Affairs at Lutheran Services in America.