Centers for Medicare and Medicaid Services Administrator Mehmet Oz and state governments will have a great deal of discretion in spending the $50 billion in rural hospital funding passed in the Republican budget bill earlier this month, leaving some experts concerned that it will become a Medicaid slush fund rather than help underserved communities.

The Rural Hospital Transformation Fund in President Donald Trump’s One Big Beautiful Bill Act was added to assuage fears from Republicans about spending reductions from the Medicaid program included in the bill.