A man who currently doesn’t have dental insurance has his blood pressure checked at a mobile dental and medical clinic in August. The Michigan Department of Health and Human Services is accepting nominations for Hometown Health Hero Awards.

LANSING — In their competition for rural health care dollars from a new federal fund, states are seeking money to bolster emergency services, address chronic diseases, and recruit and train more doctors and nurses.

All 50 states submitted their applications to the federal government last week to get shares of the $50 billion Rural Health Transformation Program.

Congress created the program in response to concern from rural health care providers — as well as lawmakers on both sides of the aisle — about the effects of Medicaid cuts in the One Big Beautiful Bill Act that President Donald Trump signed this summer.

A Stateline analysis of 10 states’ proposals to the Rural Health Transformation Program found common focus areas, including expanding mobile health care access and bolstering emergency medical services. States also focused on chronic disease prevention programs, technological advancements and rural clinician recruitment.

Stateline examined proposals from states that had large rural populations or had released their proposals. Missouri, North Carolina and Oklahoma are among a dozen states that have expanded Medicaid and would be hardest hit by rural Medicaid cuts — each seeing at least $4.5 billion in reductions over 10 years. The other states whose proposals were examined are: Colorado, Maryland, Minnesota, New Mexico, North Dakota, Washington state and West Virginia.

Rural health care leaders told Stateline that states had to rush to develop the pitches. After the official funding notice was announced by the federal Centers for Medicare & Medicaid Services (CMS), states had about seven weeks to put together their applications. Many held listening sessions with hospitals, clinics and community members, and opened public comment periods to help inform priorities. Others created advisory or working groups.

State officials and medical groups said the federal infusion of money is welcome, but isn’t enough to offset billions in Medicaid losses, and won’t be a magic bullet to solve a structural problem: a health care payment system that favors patient volume and doesn’t work for sparsely populated rural America. The new law cuts $911 billion from Medicaid over the next decade — with rural communities slated to lose about $137 billion, according to health policy research group KFF. The new rural health program could offset just over a third of cuts in rural areas, KFF estimates.

“It’s going to be a Band-Aid,” Toniann Richard, CEO of HCC Network, which runs six Missouri rural community health clinics, said about the grants. “How do we make sure that it’s not just a one-time Band-Aid — that it’s maybe a waterproof Band-Aid?”

More than 700 hospitals — roughly a third of rural U.S. hospitals — are at risk of closing because of financial problems, while rural labor and delivery units struggle to stay open and residents grapple with higher rates of chronic illness but live far from care.

Half of the Rural Health Transformation Program — $25 billion — will be distributed equally to states with approved applications, regardless of each state’s proportion of rural hospitals or population. The remaining half will be allocated by CMS based on the number of rural residents and rural health facilities in a state, as well as the state’s spending plans and policies, among other factors. CMS said it will decide on applications by the end of the year.

CMS outlined priorities for the program, with each state developing its own approach to fulfilling them. Those include technological improvements, an expanded and sustainable workforce, new ways of coordinating care and chronic disease prevention. Rural residents are more likely to die early from conditions such as heart disease. Some states proposed new screening or telehealth initiatives for those conditions.

Helping rural areas keep clinicians also was a focus across the grant proposals. Several states said they would use funds to expand rural residencies and apprenticeships for medical school graduates to try to draw more providers to their areas.

Every rural and low-population Colorado county contains areas considered EMS deserts, the state said, proposing $45 million to $55 million over the next five years to expand rural EMS.

Colorado and other states proposed increasing remote patient monitoring for rural patients living far from care. That’s a form of telehealth that helps doctors track patients’ health while they’re at home, such as through devices to monitor weight, blood pressure or blood sugar levels that send results digitally to clinicians. Doctors can then monitor for unmanaged blood sugar or sudden weight gain and discuss a plan with patients without “forcing folks to have to drive into the clinic,” said Michelle Mills, CEO of the Colorado Rural Health Center, the state’s nonprofit rural health office.

Overdose and suicide rates are often higher in rural communities; behavioral and mental health were addressed in several state applications.

West Virginia has the highest rate of opioid overdose deaths. The state released a grant proposal summary that has little information on mental health and drug use initiatives, but says addiction treatment would be “enhanced” to support a “drug-free workforce.”

North Carolina said it would grow community mental health clinics and integrate behavioral health within “regional care networks.” Colorado, New Mexico, North Dakota and Washington also proposed initiatives focused on rural behavioral health care access or suicide prevention.

New Mexico proposed establishing a grant program that would allow rural communities to apply for and create pilot projects tailored to their own specific needs, and a program for specialists to consult with each other across the state. The state also proposed $363 million toward specialty care and chronic disease management for high-risk rural groups, including planning regionalized “specialty and maternal care networks.”

West Virginia said it would create a new rural transportation system that would fund rideshare and other transportation services, as well as coordinate with EMS and hospitals to more efficiently transport rural patients to care.

States are also taking varied approaches on how they would split the funds or connect care among regions. For example, Missouri and North Carolina would divide states into regional rural “hubs,” to target different communities’ needs. Missouri would integrate rural clinics, pharmacies and public health agencies by coordinating care for patients and sharing data.

Heidi Lucas, executive director of the Missouri Rural Health Association, advised the state on its application. One advantage of that regional model, she said, is that it allows low-income community health centers — also called federally qualified health centers (FQHCs) — to take the lead in specific regions that don’t have hospitals.