Democrats are praising investments in rural health care created by President Donald Trump’s landmark tax and spending cut law after railing against the legislation for months.
The Trump administration in late December announced first-year state awards for its $50 billion Rural Health Transformation Program: a fund created by the One Big Beautiful Bill Act to help offset GOP reforms to Medicaid. Democratic governors have largely cheered the money allotted to their states despite excoriating the budget law at the time of its passage.
“Pennsylvania is home to some of our nation’s finest hospitals and health care providers, but too often folks in rural communities struggle to get access to the high quality care they deserve,” Democratic Pennsylvania Gov. Josh Shapiro wrote on X following federal officials announcing a $193 million award in the Keystone State. “This plan will change that.”
Shapiro did not disclose the funding was created by the One Big Beautiful Bill Act, which he panned during the lead-up to the bill’s passage through Congress.
“You have to ask, knowing just how harmful and unpopular this bill is: Why are they rushing to do this?” Shapiro wrote on X, referring to Republicans. “Why are they pushing so hard to screw over so many people who voted for this President?”
No Democratic member of Congress supported the budget bill’s passage, citing GOP reforms to Medicaid and food assistance programs. However, some Democrats have begun to publicly support or claim credit for popular provisions within the law, including no taxes on tips, air traffic control modernization and security funding for this year’s FIFA World Cup.
Senate Majority Leader John Thune said that he expects Democrats to also champion the rural health program, citing the fund’s expected boost to struggling health providers nationwide.
“I think you’ll see a lot of Democrats out there taking credit for the benefits that rural hospitals are going to derive from this,” Thune told the DCNF in an interview Monday. The majority leader pointed to a $189 award to his home state of South Dakota, which he described as a “godsend” for rural hospitals in his state.
“This is a clear way of ensuring that over the next five years, rural hospitals across the country are going to get a huge benefit,” Thune continued.
Every Democratic governor applied for a share of the law’s rural health care fund and federal officials have said the average award in each state for 2026 was $200 million.
The five-year program is designed to help rural hospitals stay afloat amid years of deep financial strain, though some states are proposing to use their funding to improve rural communities’ health care systems more broadly.
Shapiro is far from the only Democrat who slammed the budget law’s passage, but is changing their tune about the measure’s rural health fund.
Democratic Hawaii Gov. Josh Green argued his state’s $189 million award will “close the distance between rural communities and the care they deserve.” He argued the budget law “guts funding for healthcare” in a joint statement with Hawaii’s congressional delegation in July.
Kansas Gov. Laura Kelly, who penned an op-ed referring to the “big, beautiful bill” as a “big betrayal,” praised the $221 million award doled out by the Trump administration. The first tranche of funding will “go a long way in fundamentally changing the health care delivery system for rural communities across the state,” according to Kelly.
North Carolina Gov. Josh Stein also applauded his state’s $213 million award, which he argued will “connect more people to more high-quality health care.” He previously railed against the budget law as a “disgrace” and inflicting “devastating consequences” on North Carolinians.
Democratic Maryland Gov. Wes Moore made no mention of Republicans’ budget law in a statement touting a $168 million award.
Thune argued the rural health care fund will feature prominently in Republicans’ messaging countering Democrats’ attacks on healthcare.
“Clearly the Democrats think they have a winner by attacking Republicans for wanting to get rid of waste and fraud in Medicaid,” Thune said, adding that Democrats will always oppose reforming entitlement programs. Federal Medicaid spending is still projected to increase by 7.9% in fiscal year 2026, according to health-research nonprofit KFF.
GOP lawmakers have also sharply criticized Democrats for seeking to repeal the rural health care fund during the record-breaking government shutdown in fall 2025. Democratic leadership’s alternative bill to fund the government would have reversed Republicans’ reforms to Medicaid and repealed the $50 billion program.
“Democrats talk constantly about access to healthcare. Yet when Republicans proposed this vital rural healthcare program, every single Democrat voted against it,” Senate Majority Whip John Barrasso, the second-ranking Senate Republican, said Tuesday. “Then, Democrats disgracefully tried to defund it.”
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