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The state’s nearly $200 million Rural Health Transformation award for 2026 will help transform a “sick care” system into a health care system – a move that will require patients to be more involved in their own care, according to Health Secretary Dr. Arvin Singh.
“If we focus on prevention, if we focus on access with these dollars and strategically invest them, we could truly transform how West Virginia has been dealing with a lot of these healthcare challenges,” he said.
He said the federal award, announced last week, was “momentous.”
The state was guaranteed to receive $100 million a year for five years under the Rural Health Transformation Fund established in the One Big Beautiful Bill signed by President Donald Trump on July 4. The program aims to enhance access to care, support the recruitment and retention of the healthcare workforce, expand telehealth services, and strengthen rural health systems statewide.
“It’s almost double the base award,” Singh said. “And if you look at it per capita, you look at the surrounding states, we’ve been granted the highest dollar amount per capita than the surrounding states and I think that’s, again, kudos to the governor and the vision of the team for looking transformatively at addressing a lot of those root challenges that you hear.”
Root challenges include obesity, smoking, diabetes and substance abuse disorder are categories in which West Virginia has long had some of the worst rates in the nation.
“So if we focus on prevention, if we focus on access with these dollars and strategically invest them, we could truly transform how West Virginia has been dealing with a lot of these healthcare challenges,” Singh said.
The 2026 award is the first of five federal grants to be given to each state over the next five years – though the dollar amount for future years isn’t known yet.
The $200 million is good news for West Virginia, said Jim Kaufman, president and CEO of the West Virginia Hospital Association. But it doesn’t address the biggest challenge facing hospitals here: what to do about the pending Medicaid cuts. He said 75% of West Virginians use either Medicare, Medicaid or PEIA insurance.
“Those three programs pay West Virginia providers less than the cost of care,” Kaufman said. “So the $200 million, roughly, that we’re receiving in the Rural Transformation program is a great opportunity to support transforming the rural health care delivery system, but it’s not going to replace the $1 billion a year in cuts that we will see going forward.”
The award isn’t intended to replace those looming Medicaid cuts. In fact, Singh said, there are restrictions on how the award funds can be used. For starters, it can’t be used for brick-and-mortar costs.”
“It’s not a revenue replacement program. It’s really what I would describe as a strategic transformation fund, which is focused on modernizing care, moving away from what we’ve seen traditionally as a sick care system to a healthcare system, expanding access, improving outcomes, strengthening rural systems statewide,” Singh said.
“At the end of the day, obesity, diabetes, heart disease, substance use, those are what drive hospital closures, workforce and workforce burnout, Medicaid spending. If we don’t change those trajectories, no amount of traditional funding will save rural care,” he said.
Kaufman said some patients are expected to start losing their health care coverage this month – due to new requirements in the Medicaid program and because Congress did not reauthorize the health insurance subsidies that made coverage affordable.
But, he said, there’s a gap between the rural health award funds which should be available in the coming weeks, and the pending Medicaid cuts, “which will give Congress an opportunity to help mitigate some of those cuts, and that’s something we’re already talking to our congressional delegation about.”
Meanwhile, Singh said, the state’s approach to transforming healthcare includes everything from providing virtual care and transportation for patients in rural areas, to a strong new system for recruiting and retaining healthcare workers and tapping into alternative models of care like the Food is Medicine program.
“We want to demonstrate to all West Virginians and to our federal stakeholders and partners that we can get these dollars out to vendors and hospitals and healthcare systems who are going to actually move the needle when it comes to changing the direction, when it comes to chronic disease across West Virginia and all the other challenges we have,” Singh said.
Click here for more information on the Rural Health Transformation Fund.