The Legislature finds and declares the following:

1. (1) Alabama’s rural communities face persistent disparities in access to care, workforce capacity, health outcomes, and health care infrastructure, requiring coordinated and sustained action across state agencies, the Legislature, providers, and community partners.
2. (2) Rural health care facilities are closing and losing important specialty services due to increasing costs and the inability to recruit and retain qualified physicians and other health care professionals.
3. (3) The One Big Beautiful Bill Act, signed into law on July 4, 2025, by President Donald J. Trump, established the Rural Health Transformation Program, which authorizes states to submit plans to strengthen rural communities by improving health care access, quality, and outcomes by transforming the health care delivery system. On November 5, 2025, the state submitted its plan, known as the Alabama Rural Health Transformation Program, to the Centers for Medicare & Medicaid Services, which includes policy reforms, innovative care models, shared-service infrastructure, and workforce initiatives.
4. (4) On December 18, 2025, Governor Kay Ivey issued Executive Order No. 741 which established the Alabama Rural Health Transformation Advisory Group to coordinate policy development, stakeholder engagement, and intergovernmental collaboration.
5. (5) Collaboration among entities and individuals to expand access to health care in rural areas of the state is in the best interest of Alabama citizens.
6. (6) It is the policy of this state to improve health care access, health care quality, and health outcomes for Alabama citizens who live in one of the state’s rural counties through the Alabama Rural Health Transformation Program’s initiatives, and, where necessary, to substitute regulated collaboration and coordination for unfettered competition under active state supervision. The Legislature further articulates a state policy to displace competition in rural health care markets, when reasonably necessary to advance the purposes of this article, including authorization of conduct that may otherwise restrain trade and affect prices, markets, or output.
7. (7) It is the intent of the Legislature to exempt from state anti-trust laws, and provide immunity from federal anti-trust laws through the state action doctrine, to entities and individuals carrying out the state’s policy provided in this article.
8. (8) This article is intended to satisfy the requirements of the state-action doctrine under federal antitrust law.

(Act 2026-522, §2.)