U.S. Senators Ted Cruz and John Cornyn, along with Representative August Pfluger and other members of the Texas congressional delegation, have sent a letter to Dr. Mehmet Oz, Administrator of the Centers for Medicare & Medicaid Services (CMS), urging support for Texas’s application for funding from the Rural Health Transformation Program. The program was established earlier this year by the One Big Beautiful Bill Act and includes a $50 billion fund aimed at improving rural health care.
The lawmakers expressed concern that the current funding model may not adequately address the needs of larger states with more rural hospitals. According to their letter, “As you know, Congress approved a historic investment in rural health care earlier this year by creating this program and ensuring that states can work with CMS to determine how to use these funds most effectively to meet the needs of their rural communities. Specifically, Congress provided $50 billion for state grants, with half being distributed by CMS ‘equally among all states with approved application.’”
They highlighted potential disparities in distribution: “Under this directive, each state could receive the same amount from the pool regardless of the number of rural hospitals and providers or the size of its rural population. For example, Connecticut, which has three rural hospitals, could receive the same amount as Texas, which has 155 rural hospitals. Texas hospitals and clinics will be clearly disadvantaged under this model, while facilities in more urban states will see an unearned windfall.”
The letter also emphasized Texas’s readiness to utilize these funds effectively: “Texas is ready and more than able to meet this critical moment for improving health care access and outcomes in our rural communities. Texas will collaborate with rural hospitals, Federally Qualified Health Centers, and other providers across the state, using the funding from this program ‘to reach residents in 100% of Texas’s rural counties and make rural Texans healthy again.’”
The delegation called on CMS to consider adjusting its approach: “As you consider state applications, we ask that you ensure an appropriate balance in funding distribution and consider the increased need of a large, rural state like Texas to ensure we can make critical improvements in health care for rural Texas communities. Thank you for your careful attention to these concerns.”
This letter was co-signed by several representatives from across Texas.
Senator Ted Cruz has a history of electoral victories in his home state. In 2024 he won re-election against Colin Allred with 53.1% of the vote compared to Allred's 44.6%. In previous elections he defeated Beto O'Rourke in 2018 (50.9% vs 48.3%) and Paul Sadler in 2012 (56.5% vs 40.6%).
