New proposed federal rules targeting youth would prohibit most hospitals from providing gender-affirming care and ban Medicaid from covering such services anywhere. Our experts explore the proposals’ implications for transgender youth and their families: https://on.kff.org/4avsnRK

⚡ KFF’s Zachary Levinson writes about the site-neutral payment reform included in the CMS’s 2026 final outpatient prospective payment system rule under traditional Medicare. #QuickTake https://on.kff.org/4odNESQ

Yesterday was the last day for states to apply for the $50B Rural Health Transformation Fund. Final awards will be released in January; we've estimated how most of the fund could be distributed across states (if all states are approved, etc.) www.kff.org/state-health...

It's also unclear how much will go to rural areas. The policies and some other factors that states are scored on don't appear to have a rural focus, and some of the permitted uses are not limited to rural areas. www.kff.org/other-health...

𝐍𝐞𝐰 𝐛𝐫𝐢𝐞𝐟 looking at CMS's funding announcement on the rural health fund. One tidbit: CMS has exercise a large amount of discretion designing its allocation plan; 20 of the 23 allocation factors (allocation $25B) were not referenced in the reconciliation law. www.kff.org/other-health...

New analysis by @kff.org finds that immigrants make up 3X the share of physicians and surgeons in rural America than their share of the rural population/total workforce (14% vs. 5%). They also play outsized roles in agriculture, construction, and service occupations. www.kff.org/racial-equit...

The temporary $50 billion rural health fund in the Republican tax and spending bill gets distributed from 2026 to 2030. But, 63% of the Medicaid cuts hit after 2030. www.kff.org/medicaid/iss...

CMS just released its 2026 proposed rule for hospital outpatient payments. Among its proposals: lowering reimbursement for drug administration services at hospitals to the physician reimbursement rate. Check out our brief to learn more about site neutral policies. www.kff.org/medicare/iss...

Along with Medicaid/ACA cuts, the BBB will trigger mandatory Medicare cuts - about $45B in 2026 If cuts are proportional across providers, hospitals could see ~$17B lower Medicare payments in 2026 (larger than Medicare DSH + UCC payments) Historically Congress has stopped triggered cuts before EOY

The Senate added $50B for rural hospitals. While cutting $155B in rural Medicaid spending.

The Senate's proposed limits on state-directed payments are estimated to lower federal spending by almost $150B over 10 years according to CBO's new estimates, which would likely reduce payments to hospitals and nursing facilities in most states. www.kff.org/medicaid/iss...

About 2/3 of rural hospital closures occurred in states that did not expand Medicaid between 2014 and 2024. Unclear if the Senate's $25B rural fund would cover losses from Medicaid/ACA cuts but it's only for 5 years and rural hospitals have historically struggled to adapt to financial challenges.

The Senate's new reconciliation language would increase some Medicare payments to hospitals in Alaska and Hawaii. Recently, hospitals in Alaska had some of the highest operating margins, in aggregate. Margins in Hawaii were also above the national average. www.kff.org/health-costs...

One of the biggest flashpoints for the "One Big Beautiful Bill Act" has been its impact on roughly 1800 rural hospitals, which is why Senate Republicans are proposing a new $15 billion rural health fund. However, there are still questions and concerns about the bill 👇 (1/7)

Senate Finance language could lead to cuts in #Medicaid state-directed payments for hospitals and nursing facilities in at least 29 states. See new @kff.org analysis: www.kff.org/medicaid/iss...