Hawaiʻi received nearly $190 million from the federal Rural Health Transformation Program to strengthen the state’s health systems.
The $50 billion federal program will be distributed to all 50 states over the next five years. The program was a compromise in President Donald Trump’s megabill, H.R. 1, as the Medicaid cuts are expected to negatively impact rural health systems.
The funds will go toward workforce development, expanding telehealth, health system modernization, and supporting medical transfers between islands.
“This investment allows Hawaiʻi to finally close the distance between rural communities and the care they deserve,” Gov. Josh Green wrote in a statement.
“Whether someone lives in Hilo, Hāna, Hanapēpē or Molokaʻi, they should have access to quality primary care, behavioral health services, emergency response and modern technology, not just those who live in Honolulu.”
Healthcare Association of Hawaii President Hilton Raethel explained that the investments are needed to attract and retain health care professionals, especially on the neighbor islands.
“We have to take initiative to make ourselves attractive … radiology techs are one example, where there's a nationwide shortage, and we are working to train more of those within the state, but until we can train enough, by having a program like this, we are hoping that that will become enough of an incentive to get someone to choose Hawaiʻi,” he said.
“We want to make that attractive to individuals who are looking for jobs, apart from the fact that Hawaiʻi's an incredible place and beautiful place to live.”
A portion of the funds will also be set aside as an innovation grant that health care providers will be able to apply for.
However, Raethel explained that the added funds likely won’t be enough to stave off the impacts of H.R. 1, which will put more eligibility requirements on Medicaid recipients, resulting in people losing their health coverage.
“If they no longer continue to qualify for Medicaid, but they need services, they may go to a Federally Qualified Health Center, but there's nothing in the Rural Health Transformation Program that would offset the cost of taking care of that patient,” he said.
“They may have more staff because … the Rural Health Transformation Program. They may have an electronic medical record, so that gets paid for, so they don't have to have that cost. So there's a relationship there, but it's not a one-for-one replacement,” he said.
“We do not anticipate at all that while we're very appreciative of the Rural Health Transformation monies, they're not sufficient to offset all the potential losses from H.R. 1.”
About 95% of the state's land is considered rural.
The state expects to receive similar amounts of funding each year of the program.
