CMS announces $50B in rural health care spending for all 50 states 

WASHINGTON – The Centers for Medicare & Medicaid Services (CMS) has announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under President Trump’s Working Families Tax Cuts legislation to strengthen and modernize health care 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. 

“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’ health care. Thanks to President Trump’s leadership, rural Americans will now have affordable healthcare close to home, free from bureaucratic obstacles.”   

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, CMS says. 

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 
• Drive structural efficiency and empower community providers 
• Advance innovative care models and payment reform 

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. 
• 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. 

Go here for a state award list. 

CMS has also announced the establishment of the Office of Rural Health Transformation (ORHT) within the Center for Medicaid and CHIP Services (CMCS).