Published August 14, 2026 at 3:55 PM EDT

The Maryland Department of Health (MDH) has announced its awarding of $80 million in grant funding as a part of the state’s Rural Health Transformation (RHT) Program.

The five-year grant program was authorized last summer under President Donald Trump’s massive reconciliation package commonly referred to as the “One, Big Beautiful Bill Act” (OBBBA) or HR 1.

The $50 billion RHT program – split among the fifty states – was included in the bill as a way to help offset major cuts made to the Medicaid program, which provides health coverage for 1 in 4 Americans in rural areas.

According to estimates from the nonpartisan Congressional Budget Office, Medicaid program changes under OBBBA will reduce federal Medicaid spending over a decade by around $911 billion.

Maryland received $168 million under the RHT program, and MDH Assistant Secretary for Population Health and Strategic Initiatives Elizabeth Kromm explains the latest round of grant awards will help expand primary care access in rural communities.

“We put out a very large request for applications earlier this summer, really emphasizing partnerships, collaborations, and wanting to see proposals that worked on integrating care, improving access, bringing in technology where possible, and thinking about everything from primary care to specialty care, behavioral health, dental and so forth,” Kromm said.

She says the department received close to 80 applications from healthcare institutions and community-based organizations, and ultimately 41 projects were chosen to receive funding.

“This covers everything. So these are dollars going to all of the 18 designated counties that are rural per our state code,” Kromm said, explaining projects range from creating new primary care sites across the state, as well as more innovative projects, like using 3D printers for dental services

MDH specifically designated $6.3 million for expanding primary care in rural areas, which Kromm says will create 17,000 new care slots.

“The primary care access component is fantastic because you can put real numbers behind that in terms of how many more people will be served,” she said. “To be able to see a doctor, I mean that's real and meaningful, and those are good numbers.”

Funding will also be used for mobile clinics, expanding telehealth access and physician recruitment in underserved areas.

Kromm says a lot of the projects will be up and running very soon due to overarching federal guidelines – all awarded funding must be spent by September 2027.

While Kromm is optimistic about how the funding will help expand rural health care access, she still has concerns about just how much the program can compensate for Medicaid cuts.

“I think there's been a lot that's been wrapped in with rural health, as that rural health transformation program is the solution for so many things. When in reality, it is very restricted dollars to be used for certain purposes,” she said. “It does not fix some of the issues that have come up because of the implementation of HR 1.”

Starting Jan. 1 2027, Medicaid recipients ages 19-64 in states with expanded eligibility (like Maryland) must work 80 hours a month or enter a job training or volunteer program to maintain coverage.

Maryland leaders have been working to expand employment training programs in light of the new requirements, but the latest analysis from the Robert Wood Johnson Foundation estimates 270,000 Marylanders could lose health coverage in 2028.

MDH is already in the process of putting together its submission for next year’s RHT grant cycle, hoping to receive at least the same amount of funding in the next fiscal year.