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.
The federal government awarded Delaware $157 million this week as part of a national program aimed at bolstering rural health care across all 50 states. The initial award represents the first batch of funding Delaware hopes to receive over the next five years.
The full award amount for the state remains unclear at this time, but the state will receive at least $500 million from the federal program.
Delaware officials said they plan to use those funds to invest heavily into health infrastructure in Kent and Sussex counties, including building the state’s first medical school and two new homeless service shelters in the lower counties.
State leaders also hope to fund 13 additional programs, including additional preventative care, financial assistance for medical students that commit to working in Delaware for five years after graduation, and robust nutritional education.
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 Centers for Medicare & Medicaid Services (CMS), which will oversee the funding, said states can expect their annual award to change year over year based on performance and implementation.
CMS also said states can expect their year-two awards by the end of October next year. It’s unclear how the 15 total initiatives budgeted by the state will be impacted by the fluctuating awards.
Mila Myles, a spokesperson for Meyer’s office, called the funding a “once-in-a-generation opportunity to overhaul healthcare in Delaware.”
“We’re excited to share more details in the coming weeks, as Governor Meyer remains focused on lowering costs, improving access, and growing our healthcare workforce to benefit every family, regardless of income or zip code,” Myles said in a statement.
The governor’s office said it expects to receive the same $157 million award each year, depending on how much money it and other states spend.
Delaware’s first medical school
One of Delaware’s primary proposals with the funding included building a medical school, as it is one of the only states in the nation without one. It budgeted more than $100 million to fund its construction and operations for the duration of the grant.
At a press conference announcing the state’s application in November, Meyer said the state would seek out competitive bids from out-of-state medical schools to run the new program. But a signed agreement indicates the state is already in talks with Thomas Jefferson University, home to one of Philadelphia’s premier medical schools.
The non-binding agreement between Delaware and Jefferson, also known as a “Memorandum of Understanding,” was not publicly available prior to the state’s announcement. After a Spotlight Delaware inquiry about the agreement, officials added the document to the state’s public-facing funding application.
In the application, the state said it would open a competitive procurement process to find a “partner institution,” hire staff and develop curriculum for the program. Additionally, the state said it hopes to issue that government contract by the end of September 2026.
While the agreement was not initially part of the public application, there was a small mention of it in a letter of support submitted to the federal government by Jefferson.
Jefferson, in the agreement, said it hopes the partnership will improve access and quality of health care in Kent and Sussex counties. The agreement also says the university hopes to build a branch campus of its Sidney Kimmel Medical College somewhere in the state.
“The goal of this Collaboration is to establish a phased approach leading to the creation of a four-year medical school in Delaware,” the agreement said.
The agreement, dated Oct. 29, says Delaware will “provide all necessary and appropriate financial resources for the development, implementation, and sustainability of the branch campus.”
Delaware’s application for federal dollars through the Rural Health Transformation Program estimated the state would spend more than $100.4 million through 2031 to fund the medical school.
Additionally, the agreement says Delaware will lead development and planning of the school in tandem with other universities and hospital systems.
Jefferson already has a sizable footprint in Delaware’s medical education landscape with clinical and educational relationships with ChristianaCare, Beebe Healthcare and Nemours Children’s Hospital in Wilmington.
The agreement also says the state and university would work toward the “enhancement” of Jefferson’s current branch campus in Delaware, in which third and fourth-year residents work at ChristianaCare.
According to the state’s federal funding application, after Delaware awards a contract to an institution, it hopes to have classes begin by the end of June 2028.