Healthcare Priorities in Governors’ 2026 State of the State Addresses

Across the country, Governors from coast to coast made healthcare a centerpiece of their 2026 legislative addresses—identifying common challenges around rural access, workforce shortages, rising costs, and behavioral health, and charting a range of ambitious courses to address them.

Rural Access Gaps

Rural and remote communities have experienced losses in critical healthcare infrastructure, inherently decreasing access to essential health-related services in these communities. Rural healthcare access emerged as a universal concern highlighted in Governors’ 2026 State of the State addresses. Governors nation-wide expressed serious raising concerns about shortages in both generalist and specialized healthcare workforces, hospital closures, and worsening health outcomes for families who no longer have access to care near their homes.

“We simply cannot allow our rural hospitals to close. And we cannot accept a future where a Kentucky woman must travel several hours to give birth.”

Governor Andy Beshear

Kentucky

“Nearly 75% of North Dakota’s rural counties face primary care shortages. Over the last 20 years, health care has concentrated in our largest communities, leaving our rural residents without adequate services. These challenges demand bold action.”

Governor Kelly Armstrong

North Dakota

The Rural Health Transformation Program

In December 2025 the Centers for Medicare and Medicaid Services (CMS) awarded all 50 states federal funding through the Rural Health Transformation Program. Allowing Governors  to actionize investments in their state’s rural healthcare and public health systems, while charging them take innovative and sustainable approaches to structural change.

“Over the next five years, this program will bring nearly $1 billion to modernize rural access to care, grow our economy, and create thousands of good jobs across our state.”

Governor Josh Green

Hawaiʻi

“As soon as our plan was submitted, we moved into action — opening applications and engaging the medical community, resulting in over 250 proposals from across the state. By the end of this month, we will begin awarding contracts, turning this investment into life-saving treatment. This is how transformation begins: not with talk, but with action.”

Governor Kim Reynolds

Iowa

“Resources have become available through the Rural Health Transformation Fund…that will provide Tennessee with more than $1 billion over the next five years to transform healthcare in rural communities all across the state. That’s a billion dollars for our rural hospitals, our rural EMS, and our rural primary care doctors.”

Governor Bill Lee

Tennessee

Healthcare Workforce

From mountain states to island territories, Governors identified the shortage of trained healthcare providers as a structural barrier to healthcare access. Governors are investing in  recruiting, training, and retaining this workforce through provider rate increases and innovative partnerships for education and training.

Healthcare Technology

Many Governors previously established priorities around remote monitoring and developing regional healthcare hubs for populations in communities that may seek care in “near-by” or bordering states/territories. The 2026 Addresses identified virtual or remote healthcare as a practical answer to geographic and transportation barriers for populations in rural or remote areas. , Several Governors outlined ambitious technology infrastructure and security investments to make telehealth a durable feature of their healthcare systems.

Deregulation & Licensing Reform

A growing number of Governors in 2026 identified regulatory barriers, from outdated Certificate of Need laws to slow professional licensing processes, as significant contributors to provider shortages. Their solutions included market-based accountability, interstate licensure compacts, and streamlined credentialing that gets qualified providers to patients faster.

Healthcare Affordability & Insurance Reform

The cost of care, and the bureaucratic frictions that drives it up, was a focal point for Governors determined to deliver tangible relief to families and small businesses. From eliminating prior authorization requirements to capping what hospitals can charge, Governors described concrete consumer-protection measures that don’t require waiting for federal action.

Mental & Behavioral Health

Governors reaffirmed their committee to addressing the nation’s mental health and substance use disorder crisis by ensuring access to related services and building responsive, well-developed systems that effectively reach impacted populations. Governors  proposed changes to both systemic infrastructure and enforceable coverage standards.