Why Should Delaware Care?
Delaware ranks as the worst state in the nation for access to primary care. A new federally funded program, offering states upwards of $500 million, looks to revitalize health care in the country’s most rural areas. That money could allow Delaware to begin closing its health care gap.
Delaware officials said they hope to receive $1 billion from the federal government to invest heavily into health infrastructure in Kent and Sussex counties, including building the state’s first medical school and new homeless service shelters in the lower counties, as part of a new nationwide program meant to bolster rural health care.
Delaware applied for the funding through the “Rural Health Transformation Program,” a provision of the Trump administration’s One Big Beautiful Bill Act that earmarks $50 billion for states to improve their rural health care infrastructure.
The program was created to court Republican senators hesitant to support more than $900 billion in cuts to Medicaid, which could disproportionately impact rural communities and their health care facilities. Those cuts could also lead to privately insured patients ultimately paying more for care.
At a Wednesday press conference held at Beebe Healthcare in Lewes, Gov. Matt Meyer said he hopes the federal funds will help to “build a stable future” for the state’s rural health infrastructure.
With the state’s billion-dollar bid, officials said they hope to build a new medical school, two new Hope Centers in Kent and Sussex counties, and further develop backend technology for hospitals to streamline care.
“Those three things are our North Stars: expanding access, lowering costs and improving outcomes,” Meyer said.
According to the Centers for Medicare and Medicaid Services (CMS), half of the $50 billion is set to be divided evenly among all the approved states, meaning Delaware would receive at least $500 million if selected.
The other half of the funding will be awarded based on a “variety of factors” set by CMS, meaning the additional $500 million the state requested is not guaranteed.
Leading the project proposals is $321 million in investments for rural medical providers and federally qualified health centers to expand their services in the community and move toward more preventative care. It is followed by $192 million to help train non-physician, clinical support positions that are in demand.
Ranking third is $107 million to further telemedicine options to those in more remote areas, while the Hope Center homeless service centers in Kent and Sussex counties are proposed to receive $104 million while a Delaware medical school would receive $100 million.
No other appropriation breaks the nine-figure threshold.
When asked by Spotlight Delaware what programs the state would prioritize should it not receive that full amount, Meyer said his office would “do anything we can to get that $1 billion dollars.”
He added that if the state did not receive the full award, it would “cross that bridge” at another time.
Neil Hockstein, chair of the Delaware Health Care Commission, a public-private partnership that can conduct pilot projects to improve health care in the state, added that it is “unlikely” Delaware will receive its full ask because of the small size of the state. He said that if the state’s plan makes it past the initial application, all of the programs included in its pitch would receive some amount of funding.
Meyer said the state would use a portion of the funds to build a new medical school – the first in Delaware. When asked if he would commit to partnering with in-state universities to run the school, Meyer said he hopes to build a new campus of an “existing medical school.” Since there are none in Delaware, that means officials would likely partner with an out-of-state institution, the governor said.
Meyer added that the state is not going to build the medical school with just “one partner,” and in-state universities would be involved.
Hockstein said medical education does not rely solely on classroom time, and largely takes place “at the bedside.” He also noted that Delaware already has medical education infrastructure with its teaching hospitals.
Currently, the state’s only pathway to doctors is through the Delaware Institute for Medical Education and Research (DIMER), which reserves a handful of admission slots at Philadelphia-area medical schools for Delawareans. Only a portion of those graduates ultimately end up practicing professionally in Delaware though.
Hockstein added that “very large components” of the medical school would be located in Kent and Sussex counties.
“It is a decentralized process, and so we need to ensure that we provide all of the academic opportunities that are available,” he said.
Additionally, Meyer said that the state was eyeing locations for the potential medical school, but declined to say where.
According to the state’s funding application, leaders are committed to reducing regulations around the certificate of need process, in which the state provides oversight to hospitals hoping to expand.
The state’s current certificate of need process, run through the Delaware Health Resources Board, fields applications from the state’s health care providers and determines whether they can introduce new services or facilities into the state.
The board is meant to act as a watchdog to ensure the state does not become oversaturated with one type of service, and to vet both programs and providers wishing to offer care in Delaware.
It has long been targeted by Republicans as an example of over-regulation that spurns free market investments in the health care sector. A dozen states, including Pennsylvania, have removed their certificate of need laws in recent decades.
In a letter signed by the entirety of Delaware’s legislature, lawmakers said they would “reform” the certificate of need process “in areas where current rules may limit access or innovation, particularly in rural and underserved regions.”
The state is set to hear back from the federal government on its funding request by Dec. 31, Meyer said.