The Fed promised “radical transparency” but withheld details of the $50 billion rural fund

Drones for drug delivery. Telehealth in libraries. Health events hosted by the church.

These are some of the ideas proposed by states as they seek to win part of the new $50 billion federal rural health transformation program. Congress approved the five-year spending plan in the Big Beautiful Bill, the same law that organized nearly $1 trillion in Medicaid spending cuts.

This law is expected to have a significant impact on rural America, as the cuts are expected to reduce health funding by 100%. $137 billion More than 10 years.

So, how Rural Health Fund money is distributed is being closely watched by people like Alan Morgan, chief executive of the National Rural Health Association. State applications were due in early November, and federal officials promised to announce awards by December 31.

“Let’s be clear,” Morgan said. “Hospital CEOs, clinic directors, community leaders: they’ll want to know what their states are doing.”

As of last week, there were nearly 40 states Project novels issuedthe main part of the application, which describes their proposed initiatives. These include Maryland’s plan to create demand for healthy foods as well as increase the supply of them.

“Many children and adults in rural Maryland have low intake of fruits, vegetables and water, and engage in limited physical activity behaviors,” the state said in its request. Among other initiatives, officials propose starting mobile markets and installing refrigerators and freezers to improve access to rural areas with limited grocery stores.

More than a dozen states also released their budget reports. A few states — Idaho, Iowa, Kansas, Maine, Minnesota, New Mexico, North Dakota, Pennsylvania, South Carolina and Wyoming — have released their full orders.

KFF Health News collected and published application documents through formal and informal public records requests On the map.

Heather Howard, a professor of practice at Princeton University, said she was “pleasantly surprised by how transparent states are.” Princeton State’s Health and Value Strategies program is also Track state documents.

But others are unhappy with what federal regulators release (or don’t release). Centers for Medicare and Medicaid Services spokeswoman Katherine Howden said the orders will not be released while they are reviewed.

CMS plans to follow federal regulations Organizing competitive grant materials Howden said when releasing information about the rural health program.

In Illinois, where Democrats control state politics, Representative Nikki Budzinski joined other Democratic members of the state’s US House delegation. Send an email to CMS Director Mehmet Oz last month requesting “full and fair consideration” of their state’s request.

“I’m very worried about retaliation,” she added.