The Centers for Medicare & Medicaid Services (CMS) has announced the allocation of $50 billion in awards to all 50 states under the Rural Health Transformation Program. This initiative, established through President Trump’s Working Families Tax Cuts legislation, aims to enhance and modernize health care in rural communities nationwide. States will receive their first-year funding in 2026, with awards averaging $200 million per state.
According to CMS, this federal investment is intended to expand access to care in rural areas, strengthen the rural health workforce, upgrade facilities and technology, and support innovative healthcare models. The program addresses the needs of over 60 million Americans living in rural regions.
“More than 60 million Americans living in rural areas have the right to equal access to quality care,” said Health and Human Services Secretary Robert F. Kennedy, Jr. “This historic investment puts local hospitals, clinics, and health workers in control of their communities’ healthcare. Thanks to President Trump’s leadership, rural Americans will now have affordable healthcare close to home, free from bureaucratic obstacles.”
CMS Administrator Dr. Mehmet Oz stated: “Today marks an extraordinary milestone for rural health in America. Thanks to Congress establishing this investment and President Trump for his leadership, states are stepping forward with bold, creative plans to expand rural access, strengthen their workforces, modernize care, and support the communities that keep our nation running. CMS is proud to partner with every state to turn their ideas into lasting improvements for rural families.”
The Rural Health Transformation Program encourages states to develop comprehensive strategies focused on improving care delivery and provider support. Planned efforts include expanding preventive and primary services; implementing physical fitness and nutrition programs; strengthening emergency medical services; supporting clinical workforce training; modernizing infrastructure with telehealth capabilities; streamlining operations; testing new payment models; and promoting regional collaboration.
Funding distribution is structured so that half of the total amount is distributed equally among all approved states while the other half is allocated based on metrics such as each state’s level of rurality, policy actions affecting access and quality of care, and potential impact on community health outcomes.
Over five years (2026–2030), $10 billion will be awarded annually as part of this program. The full list of state-by-state award amounts is available on the CMS website at http://www.cms.gov/RHTProgram.
To ensure accountability and progress tracking, CMS will assign project officers for each state who will provide guidance throughout implementation. States are required to submit regular updates detailing progress toward their goals. Annual meetings at the CMS Rural Health Summit during the Quality Conference will allow states to share best practices.
Applications were evaluated through a merit review process involving both federal and non-federal experts across various disciplines relevant to rural health care. Reviewers were screened for conflicts of interest before participating in application assessments.
Additional information about state project abstracts can be found at https://www.cms.gov/files/document/rht-program-state-provided-abstracts.pdf.
