Trump administration delays rural health fund awards for 2027

Federal officials overseeing the Rural Health Transformation Program (RHTP), a $50 billion fund aimed at providing rural hospitals with multiyear funding and transforming rural healthcare delivery, recently sent a mass email to state leaders informing them that the announcement of how much funding they'll receive next year will be delayed.

In 2026, each state was awarded between $147 million and $281 million based on a federal scoring process that is to be revisited each year. State leaders then had just over seven weeks to write applications as they competed for first-year funds.

Since the launch of RHTP, state leaders have raised concerns over tight deadlines and onerous reporting demands. Lori Foley, who leads revenue and compliance advisory at consulting firm PYA, said the fast rollout of RHTP did not "set anybody up for success to make meaningful progress."

In an email sent from Alina Czekai, director of the federal Office of Rural Health Transformation, state leaders were informed that federal officials "discovered an additional administrative process requirement" and award announcements for 2027 would be delayed.

"We are working to resolve this as quickly as possible," Czekai wrote. She did not specify when the competitive portion would be announced but added that each state's budget revisions triggered by the new allocations would be "due back to CMS" by Nov. 30.

The email has added to the pressures of recent months for state leaders, with one leader telling KFF Health News the email funding alert was "cryptic" and one Midwestern state health association leader saying her staff was "in the dark over here" about funding.

(Tribble, et al., KFF Health News, 11/5)

Medicare Part D premiums expected to jump 50% in 2027

Premiums for standalone PDPs through Medicare Part D are projected to rise 50%, from $34 in 2026 to $51 in 2027, assuming current enrollees remain in the same plans, according to an analysis from KFF.

Meanwhile, KFF projected that Medicare Advantage plans that offer Part D coverage will average $9 per month in 2027, marking an increase of $2 compared to 2025.

Around 25 million seniors receive prescription drug coverage through standalone Part D plans, and three-quarters of Part D enrollees who don't qualify for financial help will see higher premiums next year if they remain in the same plan.

KFF's projection is significantly higher than CMS' projection that average monthly Part D premiums would rise less than $1 in 2027 which the agency said in a release in September. KFF researchers said that while regulators didn't explain the methodology behind that calculation, they could have accounted for plan switching.

"With some plans increasing premiums substantially, the stakes are higher this year for people with Medicare stand-alone drug coverage if they sit on the sidelines during open enrollment," said Juliette Cubanski, director of KFF's Program on Medicare Policy. "There are relatively low-premium PDP options, but people facing large premium increases need to take action if they want to avoid paying significantly more."

(Landi, Fierce Healthcare, 11/3; Parduhn, Healthcare Dive, 11/2)

CMS will appeal lawsuit over medically frail exception in Medicaid work requirements

CMS Administrator Mehmet Oz said Tuesday the agency plans to appeal last week's decision by a district court that prevents HHS from requiring plaintiff states to demand Medicaid beneficiaries prove their condition significantly impairs their ability to work before being exempted from work requirements, suggesting the suit could go to the Supreme Court.

"So the statute says you have to define the different criteria that would allow you to be exempt from the work requirement," Oz added. "There was an effort to try to define that in a way that states could actually operationalize it. The judge didn't like that."

(Ris, Inside Health Policy [subscription required], 11/3)

FDA, CDC receive lowest ratings of all federal agencies in new poll

Nearly half of Americans in a new Gallup poll said FDA and CDC are doing a "poor" job while just a quarter say the agencies are doing an "excellent/good" job — marking new lows for the agencies.

For the poll, Gallup surveyed 1,000 adults living in all 50 U.S. states and the District of Columbia between Sept. 1-17.

They found that 48% of respondents said FDA was doing a "poor" job while 26% said the agency was doing an "only fair" job and 25% said it was doing an "excellent/good" job. Meanwhile, 44% rated CDC's performance as "poor" while 30% rated it as "only fair" and 26% rated it as "excellent/good."

According to Gallup, the "excellent/good" ratings for FDA and CDC are the lowest they’ve seen since starting to track ratings of the agencies in 2003.

Trust in both agencies has changed significantly by political affiliation as well. For example, Democrats' rating of CDC has dropped 14 points this year, following a 31-point decline when the Trump administration took office and HHS Secretary Robert F. Kennedy Jr. started making sweeping changes. Before 2025, Democrats' rating of CDC had generally been positive, even during the COVID-19 pandemic.

By contrast, Republicans' ratings of CDC dropped significantly during the pandemic from 70% positive in 2019 to 16% in 2021. However, those numbers have improved from 19% in 2024 to 32% today.

Meanwhile, Republican approval of FDA rose from 23% in 2024 to 36%, while Democratic approval fell from 47% to 18%.

(Jones, Gallup, 10/15)