Urge Congress to Invest in Rural Health

On May 30, 2025, President Trump released his FY 2026 President's Budget proposal which 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.

On July 31, the Senate Appropriations Committee marked up its Labor, Health and Human Services (LHHS) FY 26 appropriations bill. The House marked up its bill on September 9. NRHA supports the robust funding levels in both chambers’ bills and urges Congress to pass a comprehensive FY 2026 to support the health of rural communities nationwide.

The Senate and House Appropriations Committee’s FY26 LHHS bill includes the following:

Medicare Rural Hospital Flexibility Grant Program (Flex) (FY 25: $64.277 million)
- Senate mark up: $66.27 million
- House mark up: $74.27 million
State Offices of Rural Health (FY 25: $12.5 million)
- Senate mark up: $13.5 million
- House mark up: $13 million
NEW! Rural Hospital Provider Assistance Program: $100 million
- This program is only proposed in the House bill
- This program is meant to make payments to eligible hospitals for maintaining health care providers. This will be a formula grant program through HRSA to support rural hospitals with low wage indexes.
Financial and Community Sustainability for At Risk Hospitals: $10 million
- This program is only proposed in the House bill
- This program will target technical assistance to rural hospitals severely at-risk for imminent closure and struggling to maintain health care services.
Rural Health Research & Policy Development (FY 25: $11.076 million)
Senate mark up: $11.076 million
House mark up: $14.076 million
Rural Residency Planning and Development Program (FY 25: $12.7 million)
- Senate mark up: $14 million
- House mark up: $14 million
Rural Communities Opioid Response Program (RCORP) (FY 25: $145 million)
- Senate mark up: $145 million
- House mark up: $145 million
Rural Hospital Stabilization Pilot Program (FY 25: $4 million)
- Senate mark up: $6 million
- House mark up: $20 million
Rural Health Outreach Services programs (FY 25: $100.975 million)
- Senate mark up: $103.975 million
- House mark up: $110.975 million
Rural Maternity and Obstetrics Management Strategies
- Senate mark up: $13 million
- House mark up: $14 million
Centers for Disease Control and Prevention (CDC) Office of Rural Health (FY 25: $5 million)
- Senate mark up: $5 million
- House mark up: $6 million
Area Health Education Centers (AHEC) (FY 25: $47 million)
- Senate mark up: $47 million
- House mark up: $47 million
Community Health Centers (FY 25: $4.26 billion)
- Senate mark up: $1.8 billion
- House mark up: $1.85 billion
National Health Service Corps(FY 25: $345 million)
- Senate mark up: $128.6 million
- House mark up: $130 million

Several additional programs play a role in delivering care and strengthening rural health infrastructure. Changes to funding of these programs include:

Oral Health Training Programs (FY 25: $41 million)
- Senate mark up: $42.6 million
- House mark up: $43.673 million
Office for the Advancement of Telehealth (FY 25: $42 million)
- Senate mark up: $42 million
- House mark up: $45.5 million
Office of Pharmacy Affairs, which administers the 340B Drug Pricing Program (FY 25: $12.2 million)
- Senate mark up: $12.238 million
- House mark up: $12.238 million
Behavioral Health Workforce Development (FY 25: $193 million)
- Senate mark up: $113 million
- House mark up: $158.053 million
Nursing Workforce Development (FY 25: $305.4 million)
- Senate mark up: $303.4 million
- House mark up: $258.629 million
Certified Community Behavioral Health Clinics (FY 2025: $385 million)
- Senate mark up: $385.5 million
- House mark up: $385 million

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.