Overview
- All 50 states received fiscal 2026 awards ranging from about $147.3 million to $281.3 million, averaging roughly $200 million, with Texas highest and New Jersey lowest under a $10 billion-per-year schedule through 2030.
- Half of each year’s money is split equally among states, while the rest is allocated using a CMS formula that weighs rural population and system metrics, proposed initiatives, and select policy actions, with annual rescoring and potential clawbacks.
- The program targets workforce growth, modernization of facilities and technology, expanded primary, maternal and behavioral health access, and testing of new care and payment models.
- Experts and advocacy groups say the fund will not fully offset projected rural Medicaid losses—often cited near $137 billion over a decade—and warn there is no guarantee states will direct dollars to the hospitals most at risk.
- CMS will assign state project officers, require yearly progress reports, and host an annual Rural Health Summit starting in 2026 to track results and share best practices.