Trump Administration Allocates $50 Billion to Enhance Rural Health Care Through Technology

By Lauren Weber

*Published: 2026-03-24*

Health Secretary Robert F. Kennedy Jr. and Centers for Medicare and Medicaid Services (CMS) Administrator Mehmet Oz have outlined proposals to address rural health care challenges using artificial intelligence (AI) and other technologies. The Trump administration has committed $50 billion over five years through the Rural Health Transformation (RHT) Program to support these efforts. All 50 states submitted applications for the program by November 5, 2025, and CMS approved proposals from every state, according to agency records.

Rural health care systems have encountered persistent issues, including limited budgets, physician shortages, and difficulties serving patients in remote locations. Officials have proposed solutions such as AI-assisted nursing, robotic ultrasounds, AI avatars for consultations, drones for delivering lab samples or prescriptions, and AI automation for administrative tasks like fax processing.

George Pink, a senior research fellow at the Cecil G. Sheps Center for Health Services Research at the University of North Carolina at Chapel Hill, described the challenges as significant. From 2005 to 2025, 195 rural hospitals closed or converted to facilities with reduced services—110 complete closures and 85 conversions—according to Sheps Center data. These closures occurred across multiple administrations, including 75 under President Obama from 2009 to 2017 and 44 under President Trump's first term from 2017 to 2021. Contributing factors include rising numbers of uninsured patients or those relying on Medicare and Medicaid, which reimburse at lower rates than private insurance.

Rural health providers have expressed a range of views on the RHT Program. Some see potential benefits from the funding, while others question its scope relative to broader financial pressures. A KFF analysis estimates that rural areas could lose $137 billion in Medicaid funding over the next decade due to cuts enacted in legislation signed by President Trump, referred to by him as the "big, beautiful bill." Providers in some states have noted that the $50 billion infusion represents a one-time allocation.

In a statement, CMS described the RHT fund's purpose: "The goal is not fewer services, rather more sustainable rural healthcare," with an emphasis on closing access gaps. The agency added that technology would support clinicians by enabling faster diagnoses, specialist input, and continuous monitoring without long travel for routine care.

State officials have proposed diverse uses for their allocated funds. North Dakota plans to use drones for rapid delivery of supplies and laboratory samples. Massachusetts intends to deploy AI support systems to deliver care to residents in isolated communities. Texas officials aim to accelerate fax processing through AI-based automation.

Alaska, which does not rely on Medicaid provider taxes limited by Congress, anticipates receiving nearly $1.4 billion over five years. State Health Commissioner Heidi Hedberg described this as an opportunity to enhance infrastructure, access, and workforce. She highlighted potential drone deliveries of medical supplies, lab tests, or medications—critical in a state where most communities lack road connections. For pregnant women, who often fly to Anchorage at 36 weeks gestation, the state plans to invest in AI for interpreting fetal heart rate patterns to detect anomalies and expedite care. "The goal is to give our providers additional tools and support so that mothers and babies receive the safest care possible, and that moms can stay in community longer," Hedberg said. She added that "AI is not the panacea—it is not going to solve everything."

In Maine, officials received nearly $1 billion over five years but stated in December that it addresses only a fraction of the estimated $5 billion funding gap projected under the new law. A research letter published this month in JAMA noted disparities in fund distribution: "States with the lowest rural mortality (Hawaii, Massachusetts, Colorado) received more than twice the per-rural-resident funding as states with the highest rural mortality," according to the authors.

Rural hospitals often face workforce shortages, with health care serving as the largest employer in many areas, according to Alan Morgan, CEO of the National Rural Health Association. He noted limitations of AI, stating, "AI is not going to treat a broken bone. AI is not going to treat a trauma case." Outsourcing such roles to external companies could have economic impacts, he added.

CMS responded that it does not intend to replace physicians but to support them. "Physicians in major urban health systems are already using AI-enabled tools, remote monitoring, predictive analytics, and digital assistants to improve care coordination, reduce diagnostic delays, and enhance patient safety," a CMS spokesman said.

Experts have raised concerns about AI reliability. A study published last month in Nature found that ChatGPT Health often misses the urgency of conditions like impending respiratory failure, under-triages issues, and fails to detect suicidal ideation. (The Washington Post has a content partnership with OpenAI, ChatGPT's creator.) Systems may not be trained to account for differences in age groups, rural versus urban populations, or racial variations.

Anthony Zizza, a geriatrician and chief medical officer at Element Care Pace, which supports older adults aging in place near Boston, highlighted risks for elderly patients with multiple chronic conditions—prevalent in rural areas. A urinary tract infection in such patients might present as confusion rather than typical symptoms, potentially evading AI detection. "It doesn’t know their medication list. It doesn’t know their home environment, their caregiver capacity and what a small change in function means for that specific person," Zizza said, noting risks of false alarms or reassurances.

Jennifer Bacani McKenney, a family physician in Fredonia, Kansas—a town of more than 2,000 residents—questioned the approach: "We’re talking about lesser, nonhuman care." She added, "We’re not lesser humans."

CMS officials stated there would be no differences in safety or quality standards between rural and urban care, and the agency would not endorse lower standards.

Proponents argue AI can address shortages through augmentation. Jason Corso, the Toyota professor of AI at the University of Michigan, leads a five-year, federally funded project equipping vans operated by physician assistants or nurses in rural areas with AI systems. These provide guidance for ultrasounds and other screenings, generate reports, and assist providers. "Many people in rural America have to drive an hour or more to reach care," Corso said. "AI is not here to replace anyone. It’s here to augment people."

Tommy Ibrahim, a physician and executive vice president and chief transformation officer at Sanford Health—a Midwest-based multistate rural health system—described AI tools that analyze data to flag risks. A risk score for chronic kidney disease tripled early-diagnosis rates since launch; a similar tool targets colorectal cancer. The system also uses AI voice technology in chats to screen for high-risk conditions and enable follow-ups in short-staffed hospitals. "Humans need to continue to be intimately connected into these workflows that are enabled by technology but not actually using the technology as a replacement," Ibrahim said. He noted the administration shares this view.

Companies are marketing AI solutions aggressively. Melinda Laird, CEO and chief nursing officer of Cordell Memorial Hospital in rural Oklahoma—which serves over 10,000 people in its county—receives five to 10 emails daily on AI deployment. The hospital has implemented some AI for documentation to save staff time but approaches interpretive AI cautiously. "I don’t feel like anything should be done without having clear oversight on it," she said.

Pink summarized provider sentiment on the RHT infusion: "There’s a healthy amount of skepticism and caution," but also "optimism that the money will be helpful in transitioning, or in helping rural hospitals meet the challenges that they’re going to be facing over the next few years."

Health Secretary Robert F. Kennedy Jr., left, and Medicare and Medicaid Administrator Mehmet Oz at a discussion on rural health care investments in January. (Brendan Smialowski/AFP/Getty Images)

Dentists care for patients at a mobile clinic in August in Terre Haute, Indiana. (Spencer Platt/Getty Images)

The RHT Program's broad state participation underscores its appeal amid longstanding rural health pressures. While technologies like AI offer potential efficiencies, their integration requires addressing technical limitations, workforce dynamics, and funding sustainability.

(Word count: 1582)