Healthcare has been a constant government obsession for decades, and over the years has continued to take gradual control over it. What is befuddling is the motive behind doing so. It is unclear just exactly what the fascination is that motivates the government to stick its nose into a person’s private health matters.
Not being enough to target the more populated areas, now the government is coming after rural healthcare.
Tucked inside the tax relief goodies in Public Law 119-21, also known as the 2025 Reconciliation Act, rather the “Big Beautiful Bill”, was the new Rural Health Transformation Program (RHTP) (pg 139 STAT 327). This program was assigned to the Centers for Medicare & Medicaid Services (CMS) to administer. In is explanation, the program “empowers states to strengthen rural communities across America by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem.” Uh-Huh.
To grab some of this money, Governor Little created the Idaho Rural Health Taskforce on October 17, 2025 to assist with the application for this program that included “representatives from the Legislature, State Board of Education, Workforce Development Council, Military Division” and “Tribal governments”. Military? Member names are a mystery. Along the way this will also flourish into “regional and strategic partnerships” that will involve “Information sharing and data use agreements” and a “secure data-sharing infrastructure”.
In its first few meetings (members still a mystery), a few topics included using the money for healthcare provider childcare, housing support, workforce assessments, wages, work based learning, expanding high school or community college healthcare profession programs, healthcare facility remodels, and digital health.
On November 4, 2025, the Idaho Department of Health & Welfare (DHW) submitted its application to CMS for RHTP funds, receiving the initial award from CMS on December 29, 2025. On January 30, 2026 DHW submitted a revised budget narrative for salary and wages, and revised budget to CMS. From February to October, 2026, Requests for Proposals and contracts were executed, and All Year funds were obligated.
DHW promised CMS it would improve rural access to care through technology; ensure accessible quality care through innovative models; sustain rural workforce with training, recruitment, and retention; implement population specific, evidence-based projects to Make America Healthy; and invest in rural health infrastructure and partnerships, pretty close to the RHTP objectives. RHTP also sneaks in artificial intelligence (AI) to rural health (Rural Cybersecurity & Artificial Intelligence Modernization Program Subgrants-pg 12) and Health Management & Data Analytics Subgrants (pg 14) which Idaho chose to adopt.
How convenient, this federal program is devised to suck massive amounts of health care data into the federal system.
Idaho Senate Bill 1453 was passed into law on April 10, 2026. Its purpose was a FY 2027 appropriation bill for DHW, establishing the RHTP fund, and creating the Rural Health Transformation Committee (members) for oversight of the program. Basically, now state agencies can engage in federal programs, decide how the money will be spent, with a state committee being assigned after the fact to watch over it without authority. Needless to say, the money will only be used for “federally approved purposes“.
What is hysterical, when one thinks about rural ares in Idaho, a few small towns might come to mind, especially those in those recreational areas. The RHTP definition lists 96% of the whole state as rural.
DHW touts its “collaboration“ with others by obtaining input from “more than 500” stakeholders and public respondents from September 5–30, 2025. Of the actual 503 respondents, 216 were public and 287 were rural health stakeholders. Doesn’t sound like this request for input was widely distributed, with what looks like a broader distribution to those who would financially gain from the funding. Those rural health stakeholders included “healthcare associations, nonprofits, RHCs, CAHs, FQHCs, primary care and behavioral health providers, dental providers, rural hospitals, independent clinics, educational institutions, Native nations” and “local governments”.
Senator Brian Lenny posted a commentary on this new program, Nobody in Idaho Voted for This, on August 4, 2026. He has legitimate concerns that the establishment of this program didn’t involve the legislature, the program answers to Washington, and in his summary the assigned Rural Health Transformation Committee will only receive a monthly summary of awards and will have no vote or approval on any award.
Sen. Lenny goes on to report that funding of around $3.1 million for the Idaho Perinatal Quality Collaborative will go to Comagine Health for consultation to “reimagine, redesign and implement sustainable improvements in the health care system.” Comagine consults with many U.S. states on healthcare. Oh, and Comagine loves to integrate data. No surprise as one of its clients is CMS. Lo and behold, the Department of Health & Human Services funds Comagine. He goes on to express concerns about conflict of interest and how decisions were made regarding this federal program.
Better healthcare my patootie. This whole government program is designed to upgrade rural infrastructure so personal health information of increased masses can be integrated into a federal digitized, data driven surveillance system. Retrofitting buildings, integrating AI, providing childcare to healthcare workers, creating career paths, and building housing…none of those seem to correlate to a diabetic getting healthier.
Nothing in this information is meant to disparage those who in reality are having difficulty getting healthcare whether it is due to cost, inability to get to medical care, or because there is limited healthcare available. It is intended to reflect how the federal government continues to encroach its objectives into states and into the personal lives of Americans.
If the powers that be really want to know the difficulty an individual experiences in obtaining healthcare, then they should be asking those individuals. Putting an individual’s health information into a data system run by AI, then sharing that information across states and with the federal government doesn’t improve anyone’s health.
