Overview
- CMS launched the five-year Rural Health Transformation Program, distributing $10 billion in fiscal 2026 with first-year state awards ranging from about $147 million to $281 million and averaging roughly $200 million.
- Half of each year’s funding is divided equally among states, while the rest is allocated by a formula weighing rural population, facility conditions, proposed policy actions and the potential impact of state plans.
- Texas received the largest 2026 award at approximately $281.3 million and New Jersey the smallest at about $147.3 million, with published state-by-state amounts for all 50 states.
- Oversight includes assigned CMS project officers, required annual progress reports, an annual rural health summit starting in 2026, yearly re-scoring of awards and potential clawbacks if states fail to meet commitments.
- CMS officials said roughly $12 billion over five years is tied to adoption of administration priorities under Make America Healthy Again, while experts warn the fund may not offset larger Medicaid cuts and may not guarantee direct relief for struggling rural providers.