(The Center Square) – The federal government dolled out $50 billion to the states to support rural health care at the end of 2025, with Nevada’s sum the eighth lowest at $180 million.
The rural cash influx will go toward infrastructural upgrades in some of Nevada’s most neglected hospitals. It comes shortly after an estimated $553 million in Medicaid was cut from the state’s rural areas over the next 10 years.
“This is the most money we’ve ever invested in rural healthcare in my lifetime,” said Gerald Ackerman, director of the Nevada State Office of Rural Health and Assistant Dean at the University of Nevada, Reno School of Medicine. Ackerman has worked in Nevada’s rural health care for over 35 years.
“So I think this is a wonderful opportunity over the next five years for states to work with local communities, to work with urban communities,” Ackerman told The Center Square.
The $180 million, announced Dec. 29, comes from the $50 billion national Rural Health Transformation Program fund included in the One Big Beautiful Bill Act passed in July. The budget reconciliation bill also cut an estimated $911 billion in Medicaid over the next 10 years.
The $50 billion from the RHTP makes up slightly more than one-third of Medicaid’s 10-year $137 billion rural spending across the country, as per a Kaiser Family Foundation study. In Nevada, the $180 million RHTP grant designated for the next five years is less than a third of the $553 million rural Medicaid the state would lose over a 10-year period, according to the KFF study.
“There will still be those [Medicaid] cuts that come, but hopefully what we can do is get the system healthier,” said Ackerman. “It’s almost like the hospitals themselves are – they’re not sick – but they’re struggling financially. They operate on some small margins. If you look at national closures for rural hospitals across the nation, it’s scary.”
The funds are designated for hospital improvements and upgrades, not to replace Medicaid payments. Between 2017 and 2024, a net of 62 rural hospitals closed across the country, with fewer than 1,800 in total, as per the KFF and the American Hospital Association. The number is expected to continue to drop with Medicaid cuts.
States individually applied for the grants, which will then decide how the money is used locally. Ackerman said the state-by-state funding was likely decided by a variety of factors, including population. “It’s not a cookie-cutter approach.”
“Thanks to this landmark investment, Nevada is positioned to make meaningful advancements in support of the state’s rural health care system,” Gov. Joe Lombardo said after the Rural Health Transformation Program sums were announced.
“These funds will help connect rural Nevadans to health care by strengthening critical infrastructure, attracting a more robust healthcare workforce, and accelerating health care technology innovation in our rural communities,” the Republican governor said.
Half of the total RHTP funds will be evenly distributed between 2026 and 2030, according to the Center for Medicaid and Medicare Services.
It is yet to be determined how Nevada’s RHTP grant money will be used. Ackerman said he was aware of some tech-focused innovations that had been proposed. “I’m hoping for some financial stability programs.”
“This is a once-in-a-lifetime investment in rural health care,” Ackerman told The Center Square. “Hopefully rural [Nevada] can be good stewards of this money and really make some impactful programs and development – to support a rural health care system that we haven’t really paid a lot of attention to for a long time.”
