Ohio Funds Rural Care Amid Medicaid Cuts
While Ohio faces a potential $33 billion in Medicaid cuts, the state is also targeting $202 million in federal rural funds toward hospitals, workforce development, and maternal care. The investment highlights a push to bolster essential services even as broader budget challenges loom.
The $202.8 million for rural health is the first of five expected annual awards from the federal Rural Health Transformation Fund, which was created as part of the Working Families Tax Cuts Act signed into law in July 2025. This initiative is designed to bolster rural healthcare providers, who are often the primary employers in small towns and crucial for emergency care. Ohio's total funding from this program could exceed $1 billion over the next five years, aiming to modernize the state's rural health systems. Ohio Department of Health Director Dr. Bruce Vanderhoff has outlined the initial spending plan, with $92 million allocated for "Rural Health Innovation Hubs" and "Clinically Integrated Networks" to improve healthcare access. An additional $21.1 million is designated for rural school-based health centers, and $13.5 million will go toward workforce development programs. A portion of the funds will also be used to upgrade emergency care and health technology. This investment comes as 25 Ohio hospitals have closed or consolidated their maternity care since 2018, with 10 of those serving rural areas. Medicaid is a significant payer for maternity services, covering 39% of all births in Ohio in 2023 and nearly half of the births in rural communities. The potential closure of more rural labor and delivery units is a major concern for maternal health advocates. From 2018 to 2022, Ohio's maternal mortality rate was 24.5 per 100,000 live births. A 2019 report from the Ohio Department of Health revealed that Black women in the state were 2.5 times more likely to die from a pregnancy-related cause than white women between 2008 and 2016. The report also found that 57% of all pregnancy-related deaths during that period were likely preventable. In Ohio, only Certified Nurse-Midwives (CNMs) are legally recognized to practice and require a written standard care arrangement with a collaborating physician. Unlike in Virginia, Certified Midwives (CMs) are not defined or licensed in Ohio, limiting pathways into the profession. Proposed changes under House Bill 537 could introduce regulations for CMs and other types of midwives, potentially expanding access to out-of-hospital birth settings. Digital health platforms are emerging as a key tool to improve maternal outcomes, especially in underserved rural areas. Technologies like the Babyscripts mobile app and telehealth services can help bridge gaps in care by providing remote monitoring, educational resources, and identifying risk factors early. These tools are seen as critical for engaging patients and supporting healthcare providers, particularly in areas facing workforce shortages.
