by James C. Sherlock

The Trump administration has announced that Virginia will receive $189,544,888 for 2026 alone to improve rural healthcare. That figure is based on an application made by the Youngkin Administration that specified how it would be spent.    

That is just a down payment. The Rural Health Transformation Program’s $50 billion in funds will be allocated to approved states over five years, with $10 billion available each year from 2026 through 2030.

While the program includes federal-level guardrails, nearly a billion dollars over five years represents a significant investment in rural healthcare in this state. The administration and the General Assembly will be lobbied vigorously to direct the funds.  

The General Assembly would be wise to ensure that the Inspector General and JLARC closely monitor:

• Where the funds are allocated,
• How they are spent, and
• The prospects for long-term returns worthy of the short-term investments.    

One undeniable challenge will be monitoring new and existing nonprofits that are already seeking shares of that funding, regardless of the state planning that has already occurred. Their costs can primarily be overhead in programs like this.  

In a one-party state with no limits on campaign contributions, the blogs and TV networks, given the withered state of our print media, will need to pay particularly close attention to those same matters.