The federal government’s Rural Health Transformation Program will issue the first of its $50 billion in grants to all 50 US states to aid rural healthcare initiatives.



RT’s Three Key Takeaways:

  1. Historic rural investment – All 50 states will receive funding under CMS’s $50 billion Rural Health Transformation Program, with first-year 2026 awards averaging about $200 million per state to expand access and modernize healthcare in rural communities.
  2. Focus on access, workforce, and innovation – The program supports strengthening the rural health workforce, upgrading facilities and technology, improving care coordination, and advancing innovative care and payment models tailored to rural needs.
  3. Equitable, merit-based distribution – Funding is split evenly among states and by need-based factors such as rurality and projected impact, following a rigorous merit review process aligned with federal grantmaking standards.


All 50 states will receive awards under the Centers for Medicare & Medicaid Services (CMS) Rural Health Transformation Program, a $50 billion initiative established under President Trump’s Working Families Tax Cuts legislation (Public Law 119-21) to strengthen and modernize healthcare in rural communities across the country.

In 2026, states will receive first-year awards from CMS averaging $200 million within a range of $147 million to $281 million. This unprecedented federal investment will help states expand access to care in rural communities, strengthen the rural health workforce, modernize rural facilities and technology, and support innovative models that bring high-quality, dependable care closer to home.

“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.”

“Today marks an extraordinary milestone for rural health in America,” said CMS Administrator Dr. Mehmet Oz. “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.”

A Nationwide Commitment to Strengthen Rural Healthcare

The Rural Health Transformation Program is a national commitment to improving the health and well-being of rural communities across the country. With this funding, states will implement comprehensive strategies to improve care delivery, support providers, and advance new approaches to coordinating health care services across rural communities. Across the country, many states are planning efforts that will:

  • Bring More Care Within Reach
  • Strengthen and Sustain the Rural Clinical Workforce
  • Modernize Rural Health Infrastructure and Technology
  • Driving Structural Efficiency & Empowering the Community Providers
  • Advance Innovative Care Models and Payment Reform

Awardees and Funding Amounts

The Rural Health Transformation Program’s $50 billion in funds will be allocated to approved states over five years, with $10 billion available each year from 2026 through 2030. As directed by Public Law 119-21:

  • 50% of the funding is distributed equally among all approved states.
    • This provides states with a strong foundation to begin implementing their Rural Health Transformation Plans; and
  • 50% is allocated based on a variety of factors.
    • As described in the Notice of Funding Opportunity, those factors include individual state metrics around rurality and a state’s rural health system, current or proposed state policy actions that enhance access and quality of care in rural communities, and application initiatives or activities that reflect the greatest potential for, and scale of, impact on the health of rural communities. All scoring factors are outlined further in the Notice of Funding Opportunity.

CMS made funding awards to all 50 states:

StateFY26 Award Amount
Alabama$203,404,327
Alaska$272,174,856
Arizona$166,988,956
Arkansas$208,779,396
California$233,639,308
Colorado$200,105,604
Connecticut$154,249,106
Delaware$157,394,964
Florida$209,938,195
Georgia$218,862,170
Hawaii$188,892,440
Idaho$185,974,368
Illinois$193,418,216
Indiana$206,927,897
Iowa$209,040,064
Kansas$221,898,008
Kentucky$212,905,591
Louisiana$208,374,448
Maine$190,008,051
Maryland$168,180,838
Massachusetts$162,005,238
Michigan$173,128,201
Minnesota$193,090,618
Mississippi$205,907,220
Missouri$216,276,818
Montana$233,509,359
Nebraska$218,529,075
Nevada$179,931,608
New Hampshire$204,016,550
New Jersey$147,250,806
New Mexico$211,484,741
New York$212,058,208
North Carolina$213,008,356
North Dakota$198,936,970
Ohio$202,030,262
Oklahoma$223,476,949
Oregon$197,271,578
Pennsylvania$193,294,054
Rhode Island$156,169,931
South Carolina$200,030,252
South Dakota$189,477,607
Tennessee$206,888,882
Texas$281,319,361
Utah$195,743,566
Vermont$195,053,740
Virginia$189,544,888
Washington$181,257,515
West Virginia$199,476,099
Wisconsin$203,670,005
Wyoming$205,004,743


CMS evaluated applications through a rigorous merit review process, consistent with standard HHS grantmaking procedures, that incorporated assessments from federal and non-federal subject matter experts with unique perspectives relevant to rural health. These individuals represented expertise across clinical, operational, workforce, technology, and payment mechanism disciplines. Reviewers were screened for conflicts of interest and did not assess applications from states with which they had personal or professional ties. Applications were evaluated using a structured scoring framework outlined in the Notice of Funding Opportunity and aligned with statutory goals, ensuring a fair and consistent process across all 50 states.