On May 30, 2025, President Trump released his FY 2026 President's Budget proposal. This proposal calls on Congress to eliminate bipartisan, fundamental, and longstanding rural health programs, such as the Medicare Rural Hospital Flexibility program, Small Hospital Improvement Program (SHIP), and State Offices of Rural Health, which are essential to ensuring access to care for rural Americans. This will upend rural health care delivery by ending proven programs, leading to a critical underfunding of rural health systems and ultimately threatening rural provider stability and patient access. NRHA is urging Congress to fund rural health in the Fiscal Year 2026 (FY2026) budget. 

The President's Budget proposal includes the following:

• Eliminating the Medicare Rural Hospital Flexibility Grant Program (Flex), which supports small rural hospital-based health care access for rural communities through working with Critical Access Hospitals (CAHs), emergency medical service (EMS), clinics, and health professionals
• Eliminating the State Offices of Rural Health
• Elimination of Area Health Education Centers (AHEC)
• Funding the Rural Residency Planning and Development Program at $12.7 million
• Funding the Rural Communities Opioid Response Program (RCORP) at $145 million 
• Investing in the Rural Health Outreach Services programs at $101 million to support rural, community-driven initiatives that improve access to care, enhance care coordination, and foster sustainable solutions to chronic disease prevention and management. 
• Funding the Public Health Leadership and Support line, which the Centers for Disease Control and Prevention (CDC) Office of Rural Health is under, at $113.570 million. 
• Investing in primary care through $1.8 billion for community health centers
• Funded the National Health Service Corps at $474 million to alleviate rural workforce shortages
• Funded the Teaching Health Center GME program at $175 million
• Several additional programs play a role in delivering care and strengthening rural health infrastructure. Changes to funding of these programs include: 
  • Eliminating Oral Health Training Programs
  • $42 million for the Office for the Advancement of Telehealth
  • $12.2 million for the 340B Drug Pricing Program and the Office of Pharmacy Affairs
  • $385 million for Certified Community Behavioral Health Clinics

Please find our FY 2026 appropriations request table here. Additionally, NRHA has created a Rural Health Appropriations toolkit to aid you in your advocacy, where you can find rural health talking points, a template letter to Members of Congress, and an advocacy campaign how-to guide. We encourage you to advocate on behalf of these requests by using the pre-drafted text in the campaign. As always, feel free to add your voice to the pre-drafted text to ensure your elected officials understand the unique needs of your community! 
 

For state-specific information on rural health federal funding in your state, please see our 2024 Federal Office of Rural Health Policy (FORHP) Funding Data by State.