Iowa’s congressional delegation pushes to secure $1 billion for rural hospitals, clinics

DES MOINES — Iowa’s congressional delegation is urging the federal government to green-light $1 billion in funding from a recently passed spending bill to go toward bolstering Iowa’s rural hospitals and clinics.

This week, Republican Iowa U.S. Reps. Mariannette Miller-Meeks, Ashley Hinson, Zach Nunn and Randy Feenstra sent a letter to Centers for Medicare and Medicaid Services Administrator Dr. Mehmet Oz requesting the department approve funding from the Rural Health Transformation Program, an initiative created by the “One Big Beautiful Bill Act” signed into law in July.

The legislation’s $50 billion initiative is aimed at helping states offset the impact of the cuts rural hospitals will face from the spending package’s billions in reductions to Medicaid and other federal health programs.

Republican Iowa U.S. Sens. Chuck Grassley and Joni Ernst also signed onto the letter.

“Iowa embodies the purpose of the (Rural Health Transformation) Program and our shared effort to make sure rural Americans have the tools they need to keep pace with today’s health system,” the letter states.

The program’s funding will be distributed to approved states over a five-year span staring in fiscal 2026 and ending in fiscal 2030, with $10 billion in funds available each year. Half the funds will be distributed equally among states, while the other half will be allocated by CMS based on various factors including rural population, proportion of rural health facilities in the state and the situation of certain hospitals in the state.

States must use funds for three or more approved uses, including chronic disease management and prevention, retaining clinical workforce talent in rural areas, information technology advances to improve efficiency, and supporting access to opioid use disorder treatment services.

CMS is expected to provide notices of state awards Dec. 31.

Earlier this month, Gov. Kim Reynolds announced that the state had applied for Iowa to receive funding, as much as $200 million annually for five years, to implement the “Healthy Hometowns” proposal. The proposal would aim to strengthen rural health care in the state through a “hub and spoke” model of care.

The initiative includes six key components:

After the GOP-backed federal spending package was signed into law this summer, some Iowa health care providers and health policy experts said that the funding for rural hospitals and clinics would not fully backfill the gap caused by reductions to Medicaid spending.

The law is projected to reduce future Medicaid spending by $941 billion over 10 years and increase the number of uninsured people by 10 million, according to the nonpartisan Congressional Budget Office.

Over the next 10 years, 37,700 rural Iowans will lose Medicaid coverage and rural hospitals will see $2.7 billion less in Medicaid funding, according to the American Hospital Association.

Iowans in Congress highlight importance of funds for state’s rural health care landscape

Miller-Meeks, who also is a physician, said she understands how rural Iowans rely on local hospitals and said the funding will improve access to health care in these areas across the state.

“Iowa has put forward a thoughtful, forward-looking plan that will improve access, modernize care, and support the providers who serve our communities every day,” Miller-Meeks said in a statement to the Quad-City Times. “I urge CMS to approve this application so we can continue building a stronger, healthier Iowa.”

Hinson called the Rural Health Transformation Program a “historic investment” and said she was "thrilled” to advocate for and support it.

“In rural states like Iowa, this fund would help our rural providers keep their doors open and adopt new technologies that make care faster, easier, and better for everyone,” Hinson said in a statement. “I will continue advocating for ways to strengthen and support rural health care for Iowans — and bring as many federal dollars back to Iowa through this fund as possible!"

Nunn said the “Healthy Hometowns” program shows how rural communities can “lead the future of health care.”

"When we passed the Working Families Tax Cuts, I fought to secure $50 billion for rural hospitals in Iowa and across the country,” Nunn said in a statement. “This investment strengthens care close to home and gives local providers the tools they need to keep serving Iowa’s families."

Feenstra said the funding would ensure Iowa families, veterans and seniors can access high-quality health care when they need it.

"Earlier this year, President Trump and Republicans passed the largest investment in rural healthcare in U.S. history,” Feenstra said in a statement. "The Rural Health Transformation Program will support Iowa’s Healthy Hometowns initiative to invest in rapid emergency response, help recruit and retain physicians, prevent and treat cancer, and support patients.”

Gazette Deputy Des Moines Bureau Chief Tom Barton contributed to this report.