Overview
- CMS released the FY2026 state-by-state allocations, ranging from $147 million in New Jersey to $281 million in Texas, with an average near $200 million.
- The five-year program will disburse $10 billion annually from 2026 to 2030 to expand access, strengthen the rural workforce, modernize infrastructure and technology, and test new care and payment models.
- Half of each year’s funds are divided equally across states, with the remainder awarded using a CMS formula that weighs rurality, facility financial health, proposed policy actions, and potential impact.
- States must submit yearly progress reports, each state will work with a CMS project officer, and CMS will convene an annual rural health summit; awards can be adjusted or clawed back based on follow-through.
- Program rules include limits such as a reported 15% cap on direct provider payments and guidance discouraging new construction, while analysts warn the $50 billion will not fully offset projected rural Medicaid losses estimated around $137 billion.