Overview
- CMS finalized $50 billion in Rural Health Transformation awards to all 50 states, with $10 billion disbursed annually from 2026 through 2030.
- Half of each year’s funds are divided equally among states and the rest are allocated by rural metrics, state policies and merit-based applications.
- First-year state awards average about $200 million and range from roughly $147 million to $281 million, with Texas ($281.3M), Alaska ($272.1M) and California ($233.6M) among the largest recipients.
- Oversight includes assigned CMS project officers, annual progress reports, a 2026 Rural Health Summit, yearly re-scoring and potential clawbacks for states that fail to follow approved plans.
- Officials say funds must modernize care models, technology and workforce capacity rather than cover legacy bills, while critics highlight a reported 15% cap on direct provider payments and concerns tied to broader Medicaid cuts.