CMS approves budget for GO-NORTH, the state’s federally funded rural health program

The Centers for Medicare and Medicaid Services approved New Hampshire’s spending plan for a large tranche of federal money that will go toward rural health initiatives, state officials announced Thursday.

New Hampshire received roughly $205 million from the federal government late last year through the federal Rural Health Transformation Program and expects to receive similar sums each year until the program concludes in 2030. The program was created by Congress in the One Big Beautiful Bill Act in an effort to counteract other provisions of the massive new law that critics argued would compromise healthcare in rural areas. It distributed money to all 50 states and instructed states to spend the money on long-term transformative solutions to rural health challenges. 

“This approval gives New Hampshire the certainty needed to move from planning to action,” Donnalee Lozeau, director of GO-NORTH, said in a statement. “Our team has worked closely with CMS, DHHS, our rural providers, workforce partners, and community organizations to build a budget that is accountable, practical, and focused on results. We are grateful for CMS’s partnership and confidence in New Hampshire’s approach.”

GO-NORTH, an office created by Gov. Kelly Ayotte to manage the money, has designated five “hubs” to distribute the funding, each focused on a category of projects. That includes the Foundation for Healthy Communities, which has been tasked with distributing hundreds of millions of dollars to projects related to expanding primary care access, behavioral health, and speciality services. It also includes both the University System of New Hampshire and the Community College System of New Hampshire, which will manage workforce training programs.

The state had an Oct. 31 deadline to get approved, and is one of the first states to do so. Wyoming’s budget for its money was approved last month, Wyoming Public Media reported.

“New Hampshire moved thoughtfully and quickly because our rural communities and healthcare providers cannot afford to wait,” Ayotte said in a statement. “I’m proud to see CMS approve GO-NORTH’s budget ahead of schedule, allowing us to get to work for patients, providers, and communities across our state. We’ll continue to lead the way in implementing our bold plan to deliver an even healthier future for all of New Hampshire.”

New Hampshire’s rural healthcare community has so far embraced the investment. However, critics have often pointed out that the $50 billion the Rural Health Transformation Program is distributing over the next five years is overshadowed by the much larger amount that other provisions of the One Big Beautiful Bill Act cut from health programs. KFF estimated soon after Congress passed the law that it will reduce federal Medicaid spending by roughly $991 billion across the next decade.