Democrats panned Trump’s signature law. Now they're touting one part

Moore this month announced his state's new efforts to expand health care access to rural Marylanders, declaring “Marylanders' ability to access affordable and quality health care should not depend on their zip code." The undertaking is funded by $168 million in federal funds that Maryland received this year from the One Big Beautiful Bill Act — the same law Democrats worked to defeat and Trump's biggest legislative achievement of his second term.

The law, which passed with only Republican votes in Congress, created the five-year $50 billion Rural Health Transformation Program, dangling federal money to states to boost health care services in rural areas. Maryland is using an initial $80 million from its tranche to expand access to primary care, mental care services and dental services in rural parts of the state.

"This $80 million allocation is another step in our administration's commitment to investing and expanding innovative initiatives to drive health outcomes for Maryland’s rural communities, leaving no one behind," Moore said in an Aug. 10 statement, without mentioning the money came from the law that's the centerpiece of Trump's economic agenda.

Like Democrats on Capitol Hill, Democratic governors fiercely opposed Trump's One Big Beautiful Bill. They slammed the legislation for extending Trump's 2017 tax cuts, allowing pandemic-era enhanced Obamacare health premiums to expire and new work eligibility requirements for Medicaid that are expected to force 7.8 million people off their health insurance by 2034, according to the Congressional Budget Office.

The inclusion of $50 billion for rural health care in Trump's megabill helped ease concerns from some Republican lawmakers about the cuts to Medicaid — an anticipated reduction of $911 billion over 10 years — and its potential impact on rural hospitals.

Democratic governors still say the infusion of cash for rural health won't soften the expected blow from the Medicaid overhaul, particularly when the new work requirements begin in 2027. But that hasn't stopped them from promoting the money that has flowed into their states — while steering clear from praising the Trump law that created the program.

"This investment allows Hawaii to finally close the distance between rural communities and the care they deserve,” Hawaii Gov. Josh Green, a Democrat, said earlier this year. He made the comment while announcing $189 million in federal rural health funds this year for Hawaii to expand quality primary care beyond Hawaii's largest city of Honolulu. 

Green previously issued a dire warning when the bill was approved in July 2025. "These next few years won’t be easy, but we are mobilizing now to respond, protect our people and make sure Hawaii can weather what’s coming," Green said in a joint statement with Hawaii's Democratic congressional delegation.

Connecticut Democratic Gov. Ned Lamont in March hailed the $154 million his state is receiving in 2026 from the rural Health Transformation Program as a "landmark federal grant" after last year warning the Big Beautiful Bill Act would have "devastating impacts on millions of Americans for years to come."

“Rural Connecticut has unique challenges, and its residents deserve the same access to high-quality care and support as anyone who lives anywhere else,” Lamont said in March. “This investment allows us to tackle those challenges head-on."

White House accuses Dem governors of taking credit for Trump program

All 50 states, Democratic- and Republican-led, applied for and received funding from the Rural Health Transformation Program, ranging from $147 million (New Jersey) to $281 million (Texas) for the first year of implementation. Grants were awarded in December 2025.

The White House accused Democratic governors of now seeking credit for a key component of a federal bill they bashed repeatedly and worked to defeat.

"Every single Democrat voted against the Rural Health Transformation Fund, and Democrat governors spent months blasting the bill that created it," White House spokesman Kush Desai said in a statement to USA TODAY. "Democrat governors have no right to now try to take credit for ‘securing’ rural health dollars that they had nothing to do with — these investments are solely thanks to President Trump and Republicans."

The pushback mirrors criticism President Joe Biden’s White House lobbed at Republican lawmakers who voted against Biden’s 2021 infrastructure law but showed up at ribbon-cuttings for projects funded by it.  

To receive the rural health care funding over the next five years, states submitted their own plans aimed at expanding access to care in rural communities, modernizing rural hospitals and technology and bringing new medical innovation to rural areas.

“Rural Arizonans have waited too long for healthcare that meets them where they are, and we’re changing that,” Democratic Arizona Gov. Katie Hobbs said in March after launching her state's rural health care program and website funded by $167 million from the federal law. She called the initiative "a signal that help is on the way.”

Pennsylvania Gov. Josh Shapiro, a Democrat, said his state's $193 million in federal funding in 2026 is allowing the commonwealth to move forward with its "plan to improve rural health care, attract and retain a skilled workforce, promote long-term, sustainable access, support the growth of innovative care, and foster technological innovation."

Still, Democratic governors said the additional funding for rural health care won't offset the loss in Medicaid funding expected in the coming years ‒ nor does it erase cuts to food stamps and other reductions to the social safety net from the Big Beautiful Bill Act.

“Governor Hobbs has been clear that the partisan Washington budget will have devastating impacts on the people of Arizona and that the RHTP is a bandaid on a gaping wound created by the federal government," said Christian Slater, a spokesman for Hobbs. "But the governor will unapologetically fight for every dollar she can to protect Arizonans from the federal government’s attacks on affordable and accessible healthcare.”

Cathryn Vaulman, Lamont's communications director, said the Rural Health Transformation Program "cannot come close to offsetting the harm caused by Congressional Republicans’ cuts to healthcare, food assistance, and other benefits in H.R. 1." She said the funding "nevertheless provide important resources to strengthen rural health care in those communities.”

Democratic Michigan Gov. Gretchen Whitmer last December said her state's $173 million 2026 allotment "will support access to health care for rural communities across Michigan as we deal with funding shortfalls caused by federal Medicaid cuts."

Despite Maryland's infusion of federal rural health care funding, Moore spokesman Ammar Moussa said the governor still believes Congress was wrong to approve Trump's megabill.

"Taking advantage of one worthwhile provision does not change the governor’s view of a law that makes deep cuts to Medicaid and will cause close to 200,000 Marylanders to lose health coverage," Moussa said. "But once Congress passed the law, Governor Moore was never going to leave federal resources on the table that can help Marylanders."

Will Medicaid cuts outweigh funding infusion in rural areas?

Medicaid covers 16.1 million people in rural areas, or about one in every four adults, according to KFF, an independent organization that conducts health care research.

A KFF analysis found Medicaid spending is expected to decline by about $137 billion in rural areas because of Trump's megabill, meaning the $50 billion in rural health care funding only offsets about a third of the loss. States with large rural populations that expanded Medicaid under the Obama-era Affordable Care Act are expected to see the largest decreases in Medicaid spending.

The White House has countered such analyses by arguing only 7% of Medicaid funding goes to rural hospitals. Any cuts to Medicaid as a result of the law, according to the White House, are from work-requirement provisions that are popular among Americans and designed to ensure only people who need Medicaid are enrolled in the program.

White House officials also contend the $50 billion is intended to address long-standing health care needs in rural areas brought on by declining rural populations over decades — not to make up for reduced Medicaid spending in Trump's bill.

Colorado, led by Democratic Gov. Jared Polis, in June issued a request for applications from organizations to help carry out its rural health care plan after receiving $200 million in year one funds. Colorado is prioritizing 29 rural counties with high rates of chronic disease and 23 frontier counties that lack critical specialty care access such as behavioral health, obstetric and gynecology services

“By taking advantage of every opportunity to reduce healthcare costs and support rural communities Colorado can increase access to the care we need to thrive, in urban and rural communities," Polis said.

But Eric Maruyama, a spokesman for Polis, in a statement to USA TODAY reiterated the governor's opposition to the One Big Beautiful Bill Act, saying it "does significant harm" through cuts to food stamp assistance, reductions to Medicaid and by allowing the enhanced ACA subsidies to expire.

"It also ripped an immediate billion dollar hole in our state budget," Maruyama said. "Congress nevertheless passed the law, and Colorado will not leave federal funding on the table, especially given the enormity of the cuts to services the law creates."