Alternative Headline: Rural Health Faces Medicaid Shifts
[MM Curator Summary]: Under federal law H.R. 1, the Rural Health Transformation Program, $50 billion is designated for rural healthcare—$25 billion allocated equally among states and $25 billion available competitively.
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Eastern Shore Rural Health System, Inc. is reviewing recent federal and state actions related to Medicaid eligibility and rural health funding.
CEO Jeannette Edwards stated that the organization is tracking developments following Governor Glenn Youngkin’s Executive Directive Twelve, signed August 13, 2025, and the Centers for Medicare & Medicaid Services’ nationwide initiative to remove ineligible Medicaid enrollees announced this week.
Under federal law H.R. 1, also referred to as the Rural Health Transformation Program, $50 billion has been designated to support rural health care. Half of the funding will be distributed among all 50 states, while the remaining $25 billion will be available to states through competitive applications. Executive Directive Twelve requires Federally Qualified Health Centers to participate in creating Virginia’s Rural Health Transformation Plan in order to compete for these additional funds. Eastern Shore Rural Health qualifies as a Federally Qualified Health Center and is preparing to provide input.
The directive also notes upcoming changes to Medicaid. Federal guidance on work and community engagement requirements for Medicaid recipients is due by December 31, 2025. Until that information is issued, Virginia has not provided details to Community Health Centers, including Eastern Shore Rural Health, on how the requirements will be implemented.
In addition, changes connected to the Personal Responsibility and Work Opportunity Reconciliation Act (PRWORA) could alter Medicaid eligibility for certain non-U.S. citizens. The Trump administration has expanded the definition of “federal public benefit” and revised eligibility standards for immigrants holding various visas. Eastern Shore Rural Health noted that the implications of this reinterpretation will not be clear until further federal direction is issued.
Edwards said the organization will continue monitoring policy developments from both Washington, D.C., and Richmond, and will provide updates to the community as more details become available.
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