This bill aims to repeal specific changes made by the One Big Beautiful Bill Act (Public Law 119-21) concerning Medicaid. It specifically targets provisions related to State provider tax authority and State directed payments , seeking to restore the prior legal framework for these aspects of Medicaid funding. Additionally, any appropriations previously made under the repealed section for State directed payments would be rescinded. Beyond these repeals, the legislation significantly increases funding for the rural health transformation program . It proposes an additional $10 billion annually for fiscal years 2031 through 2035, providing a total of $50 billion in new funding to support rural healthcare initiatives.