A slate of governors identified health care as one of the defining challenges facing the country, particularly in rural regions.
Arizona Governor Katie Hobbs joined Cox and three other counterparts from Hawaii, Montana, and Utah at Omni Scottsdale Resort & Spa at Montelucia for the Western Governor’s Association’s winter meeting on Thursday, Nov. 20.
On Nov. 5, Hobbs announced that Arizona submitted the state’s application for Rural Health Transformation funding. The program was authorized by One Big Beautiful Bill Act to help offset the impact of the law on rural areas, since it slashes about $1 trillion to Medicaid over the next decade.
Questions remain about which states will receive funding and how much.
The $50 billion program was designed to support health care access in rural communities through investments in health care workforce and technology.
Hobbs raised a concern on application priority to Health and Human Services Secretary Robert F. Kennedy Jr., a keynote speaker at Thursday’s event.
“Significant portions of the funding will be allocated exclusively to the five states with the greatest land areas. Arizona is the sixth,” Hobbs said.
The first $25 billion of funding will be distributed equally among states whose applications are approved.
For the second $25 billion in funding, officials will follow a set of criteria which include the following:
- Assessing land mass.
- Assessing uncompensated care as a percent of hospital operating expenses.
- Formally prohibiting Supplemental Nutrition Assistance Program, or SNAP, benefits from paying for unhealthy food.
Five percent of the second $25 billion is based on the geographic size of a state, which will benefit the five largest states: Alaska, Texas, California, Montana and New Mexico. The remaining 45 states are not considered for this portion of funding.
Hobbs called the five-state priority “arbitrary” and said it would punish western states with significant land mass.
“I want to know if you can make assurances to us and other large states that we will be allocated the money that we need to take care of our vast, rural and dispersed rural populations,” Hobbs said.
But Kennedy said he could make no guarantees.
“That formula, as you know, was decided through negotiation in the legislatures and the Senate and the House…” he said.
As the head of the Health and Human Services Department, Kennedy said he has no control over altering the formula but that he thinks “Arizona has a very good application.”
The Centers for Medicare & Medicaid Services determines which states receive funding for rural health transformation applications after reviewing the states' submitted plans.
States expect to learn of their application status by the end of the year.
What is the Rural Health Transformation program?
According to a Kaiser Family Foundation report, the Rural Health Transformation program was authorized by One Big Beautiful Bill Act to help offset the impact of the law on rural areas, which includes an estimated $911 billion in federal Medicaid spending reductions over the next 10 years.
That includes an estimated $137 billion in rural areas based on KFF estimates, in light of ongoing concerns about the financial vulnerability of many rural hospitals and reports of hospital closures.
Health industry leaders in southern Arizona have criticized the Rural Health Transformation program. Clint Kuntz, the CEO of El Rio Health, noted at an Oct. 28 panel in Tucson that the program is "not to replace loss of dollars" and is only for five years, with a focus on technology implementation.
Kuntz was one of about 250 stakeholders who collaborated with Hobbs on the state’s RTA application.
#RFK Jr. defends stance on vaccines amid ongoing measles outbreak
Arizonans are bracing for cuts to Medicaid as the state is experiencing an outbreak of measles, a vaccine-preventable disease, along the Utah border.
Arizona documented 137 cases in 2025, with most cases recorded in Mohave County, and Utah documented 87 cases as of November 18.
Measles is highly contagious and particularly dangerous for babies and young children.
“I'm not trying to take anybody's vaccines,” Kennedy said. “I can tell you that any changes… will leave the option of people to vaccinate who want to take whatever vaccines they want.”
Kennedy said his objective is to make sure that vaccines are properly tested so that their risks and benefits are definitively known through observational studies.
Hawaii governor Josh Green, a medical doctor, said he worried that visible disagreement on vaccination could lead to “policy change de facto” by people choosing to stop vaccinating when leaders are unable to execute existing policy.
Kennedy has faced backlash for his lax stance on vaccines among a slew of other controversial policies.
In April, Kennedy held a news conference at the Arizona State Capitol in Phoenix where he defended the government’s response to the ongoing national measles outbreak.
“What we’re doing right here in the United States is a model for the rest of the world,” he said at the Phoenix news conference.
When reporters attempted to ask follow-up questions about the measles, mumps, and rubella (MMR) vaccine, they were shouted down and booed by attendees and staff.
In June, Kennedy removed all 17 members of the CDC's Advisory Committee on Immunization Practices, citing concerns about conflicts of interest within the committee and wanting to restore public trust.
NPR reported on Nov. 21 that the CDC website now says a link between vaccines and autism cannot be ruled out. That's a reversal from the CDC's longstanding stance that there is no link.
The change comes even though a connection between vaccines and autism has long been debunked by a large body of high-quality research. But Health Secretary Robert F. Kennedy Jr. has long promoted the discredited claim.
Kennedy did not respond to reporters’ questions at the conclusion of Thursday’s panel discussion.
