Overview
- CMS published fiscal 2026 allocations on Dec. 29, with first‑year awards averaging about $200 million and ranging from New Jersey’s roughly $147 million to Texas’s about $281 million.
- The five‑year program disburses $10 billion annually from 2026 to 2030, splitting each year’s funds evenly across states for half and awarding the other half based on rural metrics and state proposals.
- Officials say the initiative aims to expand preventive, primary, maternal and behavioral health services, strengthen rural workforces, modernize infrastructure and technology, and test new care and payment models.
- Implementation includes CMS‑assigned project officers, annual progress reports, a yearly rural health summit, and the ability to re‑score states and claw back funds if promised policies are not carried out.
- Policy experts warn the fund may not offset projected Medicaid reductions estimated at roughly $137 billion over a decade, and some allocations are linked to contested policy priorities such as SNAP‑related measures.