A Preview of Federal Priorities

Earlier this month, the Trump administration released the Spring 2025 Unified Agenda of Regulatory and Deregulatory Actions (Agenda). This document functions as the government’s to-do list, offering a preview of upcoming rulemakings across federal agencies before they ever hit the Federal Register. For state leaders, it is one of the best early indicators of where federal policy is headed and when to weigh in before key decisions are locked in.

This edition of Dispatch from DC highlights items from the Agenda that could have the greatest impact on state and local governments. These are rules still in the planning stage, which means there is an opportunity to shape their direction.

On Monday, the Centers for Medicare & Medicaid Services (CMS) released the much-anticipated details on the new Rural Health Transformation Fund, a $50 billion program created under the rebranded Working Family Tax Cuts Bill (formerly the “One Big Beautiful Bill”). The fund will issue grants to states over the next five years, and we highlight key takeaways from the newly released guidance.

The Unified Agenda: A First Look at Federal Priorities

The Unified Agenda isn’t just a filing cabinet of federal intentions, it’s a chance for state leaders to position themselves early in the rulemaking process. Because many of these actions are only at the planning stage, agencies are still weighing options and open to ideas on how to improve the policy. That means state leaders who move now can shape the contours of regulations before they harden into formal proposals.

For our network, the Agenda is especially valuable for spotting:

  • Rules that revisit prior federal overreach, offering a window to reassert state authority.

  • Programs that shift costs to states and may require legislative or budget adjustments.

  • Opportunities to showcase state reforms as working models that Washington can adopt.

What follows is a selective set of rules under consideration and not yet open for public comment. This is not a comprehensive list, but it highlights the rules most likely to affect state and local governments and where early engagement could make an impact:

Department of Agriculture

Department of Education

Environmental Protection Agency

Treasury

Department of Transportation

Department of Labor

Department of the Interior

Department of Homeland Security / FEMA

Department of Health & Human Services

Department of Energy

How States Leaders Can Engage Now

  • Scan the Unified Agenda: Review both the items above and the full Agenda for possible rules that would impact your state.

  • Flag Issues of Interest: Let us know which proposals matter most - we can help identify timing and strategy for engagement.

  • Use Best Practices: SPN’s Center for Practical Federalism can assist with early outreach, preparing public comments, and ensuring your state’s perspective is heard.

By acting early and strategically, states can ensure Washington’s decisions strengthen, not sideline, the principles of federalism. Contact Jennifer Butler at butler@spn.org for more information.

Rural Health Transformation Fund: What States Should Do Now

CMS has released the full Notice of Funding Opportunity for the Rural Health Transformation (RHT) Fund, a $50 billion grant program to be distributed over five years (FY 2026–2030). Half of the funding ($25 billion) will be split equally among states, $500 million per each state. The other half will be awarded through a points-based formula that combines rural and hospital data with a technical score tied in part to state policy actions. Applications are due November 5, 2025, with awards finalized by December 31, 2025.

Key policy levers in the scoring formula include:

  • SNAP waivers restricting “non-nutritious” items like sugary drinks and candy.

  • Reestablishing the Presidential Fitness Test.

  • Certificate-of-Need reform, licensure compacts, and scope-of-practice expansion.

  • Allowing short-term, limited-duration insurance.

  • Expanding remote care through telehealth access.

Immediate steps for state leaders include:

  • Ensure there is a governor-led application team that includes health and human services officials, rural providers, and good-government stakeholders.

  • Leverage partial credit for future policy changes by moving quickly on waivers, compacts, or executive actions, even if full enactment waits until 2026.

  • Encourage transparency and accountability by building in clear reporting, stakeholder input, and public-facing updates to strengthen your application and set reforms up for long-term credibility.

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