Governor Kay Ivey convened the first meeting of the Alabama Rural Health Transformation Advisory Group on Wednesday, the panel she created by executive order to guide policy for the state’s Rural Health Transformation Program.

The meeting follows the Trump administration’s notification that Alabama will receive $203,404,327 in first-year funding for the initiative.

“Today’s inaugural meeting is an important step toward implementation of our rural health strategy,” Ivey said. “The Trump administration has entrusted Alabama with significant funding to make generational reforms to an important but struggling portion of our health care system. We have an excellent group of legislators to help us be successful, and I am excited to see what they come up with.”

Advisory group members are House Speaker Nathaniel Ledbetter, Senate President Pro Tem Garlan Gudger, Senator Greg Albritton, Senator Clyde Chambliss, Senator Donnie Chesteen, Senator Bobby Singleton, Representative Anthony Daniels, Representative Jamie Kiel, Representative Rex Reynolds and Representative Pebblin Warren.

During the session, members elected Chesteen chair and Kiel vice chair. Kenneth Boswell, director of the Alabama Department of Economic and Community Affairs—the agency administering the program—outlined the initiative. Members then questioned Boswell and discussed timelines, processes and possible legislation to support implementation.

Ivey said she wants the group to craft policy changes that keep the program effective long after the federal money is spent.

“To turn around our rural health care system—to make it financially sustainable and available to deliver lifesaving care to all Alabamians—we must rethink how things have always been done,” she said. “That means thinking critically about policies, regulations and even the way health care providers operate.”

In her January 13 state of the state address, Ivey challenged health care leaders “to work with us in thinking outside the box and identifying new partners as we strive to improve health care in Alabama.”

Congress created the federal Rural Health Transformation Program in the One Big Beautiful Bill Act, which President Trump signed July 4, 2025.

Chesteen called the Alabama program “a once-in-a-generation opportunity to strengthen health care access in our rural communities.”

“By bringing together legislative leaders and health care stakeholders, we are positioning Alabama to make smart, sustainable reforms that will improve patient outcomes and ensure rural hospitals and providers can continue serving families across our state,” he said. “I look forward to working with Ivey and my colleagues to turn this historic investment into lasting results for the people of Alabama.”

The five-year, $50 billion federal program empowers states to improve rural health care access, quality and outcomes by transforming delivery systems, according to Ivey’s office.

Kiel said the initiative will guarantee “that every Alabamian, no matter where they live, has access to the quality care they deserve.”

“We want to build a stronger, healthier future for our rural communities and I am proud to support an initiative that ensures Alabama remains a great place to live, work and raise a family,” he said.

Alabama’s award-winning proposal, the Alabama Rural Health Transformation Program, outlines 11 targeted initiatives to improve health care delivery and patient outcomes in rural parts of the state.

A 2024 report from Americans for Public Trust found that a Swiss billionaire funneled close to $100 million through a dark money organization to influence state ballot campaigns across the country, including measures on abortion, election law, redistricting, and minimum wage.

On Tuesday, the Alabama House moved to ensure that kind of influence doesn’t reach the state.

HB214, sponsored by State Rep. James Lomax (R-Huntsville), prohibits foreign nationals from directly or indirectly donating to political candidates or political action committees in any Alabama election, including races involving candidates, constitutional amendments, or referendums.

The bill passed the House and now heads to the Senate.

Under federal law, foreign nationals and business entities are already banned from contributing to political candidates and committees. However, loopholes have allowed foreign funding to influence ballot measures such as constitutional amendments and referendums.

“Elections should be decided by the people who live, work, and raise their families in this state – not by foreign entities with ulterior financial or political motives,” Lomax said.

“This is beyond alarming, and I am proud to have passed legislation that slams the door shut on international dark-money groups seeking to bring their views to our great state.”

Alabama joins a growing number of states considering legislation to close the foreign funding loophole.

Tuesday was the day nine of the 2026 state legislative session.

Sawyer Knowles is a capitol reporter for Yellowhammer News. You may contact him at [email protected].