State Rep. Dave Prestin today slammed the Michigan Department of Health and Human Services after officials announced a deeply flawed proposal to distribute federal rural healthcare grants – one that would force sparsely populated Upper Peninsula counties to compete directly with Michigan’s most populous counties, including Wayne and Oakland.

“If Lansing bureaucrats are prepared to label Detroit as ‘rural,’ then the state has effectively abandoned any meaningful definition of rural life,” said Prestin, R-Cedar River. “If Greektown now meets the definition of country, Delta County must be considered rugged wilderness.”

The Rural Health Transformation (RHT) program was created under the One Big Beautiful Bill Act of 2025 to improve healthcare access and outcomes in rural communities. States were authorized to apply for a share of $50 billion in federal funding over the next 5 years.

Despite ranking among the top ten states for rural population, Michigan received just $173.1 million – placing it in the bottom ten states nationwide. Neighboring states such as Iowa ($209 million) and Ohio ($202 million) secured significantly more funding. Prestin and other House Republicans say Michigan’s low allocation reflects a poorly prepared application submitted by MDHHS and the overall incompetence exhibited by the department.

They argue that MDHHS not only failed to secure adequate federal funding, but it then expanded eligibility definitions in a way that allows Michigan’s largest cities and counties – historically Democratic strongholds – to capture a disproportionate share of rural healthcare dollars.

“Once again, rural Michigan – and especially the Upper Peninsula – is shoved aside by Lansing bureaucrats,” Prestin said. “Big population centers muscle their way to the front of the line for dollars that were meant for rural communities, leaving the people who actually need them with little more than leftovers.”

MDHHS serves as a passthrough agency for RHT grants. Under the department’s criteria, any county deemed “rural” or “partially rural” qualifies for funding, allowing any entity within that county to apply so long as the proposal claims to support rural healthcare.

As a result, all of Wayne County – with roughly 1.8 million residents – qualifies for RHT funding, despite MDHHS identifying only about 100 residents as living in rural areas. Meanwhile, grants must be awarded and distributed by December.

House Republicans also criticized MDHHS for withholding nearly $19 million from Michigan’s RHT allocation for administrative costs, including $2 million for salaries, benefits, and travel for 12 new positions – averaging nearly $170,000 per employee.

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