"50% of our hospitals are operating with a less than 1% margin. It's just they're hanging on by a thread," Toni Lawson said.Lawson is the Idaho Hospital Association chief advocacy officer. She says this is the first time in her 20 years with the association that she's been nervous about potential hospital closures in Idaho.The financial challenges facing rural hospitals stem from recent federal budget cuts.The One Big Beautiful Bill Act, passed by Congress last summer, cut $150 billion from Medicare and Medicaid nationwide over 10 years.Now, the Trump Administration has created the Rural Health Transformation Program, which will send $50 billion to states across the country to help them improve rural healthcare access, quality, and outcomes.Idaho was approved for approximately $186 million a year for five years, though this amount could change based on federal discretion.That money would help hospitals like Valor Health in Emmett.Watch to hear from Valor Health and Idaho Hospital Association leaders about what's next for rural hospitals. Idaho's rural hospitals await federal grant funding as financial struggles continue"Margins are really tight. We've had negative income the last two months, as an example, so it's, you know, it's razor thin," Brad Turpen said.Turpen is the CEO of Valor Health. Despite the challenges, he says the hospital has been strategic about investments and services."We've also been really aggressive in grant funding and other federal dollars, you know, an example is we now have oncology and chemotherapy. We were able to do that because of COVID dollars,," Turpen said.RELATED | How a new $50 billion CMS program plans to transform rural health care in all 50 statesThe hospital has had to make difficult decisions about which services to continue."We set up a service, and it just wasn't quite working," said Turpen. "It wasn't really serving the population the way we thought it was going to be, and we just said 'it doesn't make sense for us to continue to do this, we'll take a different path,'" Turpen said.All 27 rural hospitals in the state can submit funding proposals for projects they need most. "If the money came to us, here's how we would use it: workforce investment, we have an aging facility, we have equipment that needs to be replaced," Turpen added.Valor Health's wish list includes upgrading infrastructure, adding modern equipment, and building services designed to keep patients in Emmett for care."We're trying to be thinking five, 10 years down the road, what's the population gonna look like? That's one thing that I think our board of trustees does a really good job of, [which] is that envisioning what the future could look like and how we could shape it," said Turpen.Turpen sees the funding as a catalyst for long-term sustainability rather than ongoing operations.RELATED | Healthcare takes center stage at panel discussion as Idaho Legislature begins 2026 sessionOne example is outpatient dialysis services."Outpatient dialysis, where patients with chronic kidney disease in our community could come to our clinic and get those services, that's one where we really feel like some upfront investment could help us get that kick-started and then we can kind of take it from there," Turpen said.Lawson emphasizes the broader impact of rural hospitals on their communities."Healthcare is an important part of the infrastructure, and we need to keep up with growth. We need to make sure there's access to healthcare in as many communities as possible," Lawson said.The state will review hospital proposals this spring, with final funding amounts expected later this year. ...read more read less