State Rep. Parker Fairbairn today raised the alarm about a proposal from the Michigan Department of Health and Human Services (MDHHS) that would force sparsely populated counties in Northern Michigan and the Upper Peninsula to compete directly with Michigan’s most populous counties, including Wayne County and Oakland County, for federal rural healthcare dollars

“Michigan health officials have designed a program where major urban counties, such as Wayne and Oakland, compete for federal funds that should be directed to truly rural communities like those in Northern Michigan and the Upper Peninsula,” said Fairbairn, R–Harbor Springs. “This is an unconscionable misuse of resources, seemingly designed to garner political favor rather than strengthen the rural healthcare workforce or modernize facilities and technology in chronically underserved areas.”

Created under the One Big Beautiful Bill Act of 2025, the Rural Health Transformation (RHT) program provides $50 billion over five years to improve rural healthcare. Despite ranking among the top ten states for rural population, Michigan received just $173.1 million – placing it in the bottom ten nationwide. Fairbairn and other House Republicans say the shortfall reflects a poorly prepared application by MDHHS.

Lawmakers argue that MDHHS not only failed to secure adequate federal funding, but then broadened eligibility rules to allow large urban counties – many Democratic strongholds – to capture rural healthcare dollars, potentially risking federal claw backs or future penalties. Acting as the RHT passthrough, MDHHS classifies entire counties as “rural” or “partially rural,” enabling entities across those counties to apply; as a result, all of Wayne County, with 1.8 million residents, qualifies for funding despite the department identifying only about 100 rural residents, with grants required to be awarded by December.

“There is real concern that if MDHHS follows through with this plan and awards rural healthcare dollars to urban communities, federal officials will view it as a violation of the intent of these funds and decide to claw back any remaining dollars,” Fairbairn said. “That could jeopardize millions – both funding Michigan has already received and future grants. Why would the federal government trust us with more if state officials mishandle what they’ve already been given?”

Local health professionals are encouraged to apply for appointment to the Michigan Rural Health Transformation Advisory Council, which will play a key role in shaping and supporting implementation of future RHT program funds. More information can be found here.

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