$50 billion was awarded to strengthen rural health in all 50 states.
The Centers for Medicare & Medicaid Services (CMS) recently announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under President Donald 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.
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.
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: States will advance Make Rural America Healthy Again goals by expanding preventive, primary, maternal, and behavioral health services and creating new access points that bring care closer to home and help preserve strong local health systems. Many states are implementing evidence-based, outcomes-driven strategies—such as physical fitness and nutrition programs, food-as-medicine initiatives, and chronic disease prevention models—to address root causes of diseases and manage chronic conditions. States will also strengthen rural emergency care through improved emergency medical services (EMS) communication, treat-in-place options, and coordinated transfers.
- Strengthen and Sustain the Rural Clinical Workforce: States will support clinical workforce training, residencies, recruitment and retention incentives, and new pathways that help students begin health care careers in their own communities. States are also investing in programs to train and support the existing clinical workforce and build futures close to home.
- Modernize Rural Health Infrastructure and Technology: Investments will modernize rural facilities and equipment; strengthen cybersecurity and interoperability; and expand telehealth, remote patient monitoring, and digital tools that enable timely access to care. States are also exploring the use of technology such as AI scribes and clinical workflow improvement tools to reduce burdens on clinicians.
- Driving Structural Efficiency & Empowering the Community Providers: States will prioritize streamlining operations, empowering providers to enhance coordination of care and resources, and building partnerships across the state with the goal of keeping care local. This includes establishing specialized hub-and-spoke models, rural regional centers of excellence, comprehensive data-sharing platforms, and rural clinically integrated networks.
- Advance Innovative Care Models and Payment Reform: States will test new primary care and value-based care models, strengthen partnerships among rural and other providers, and promote regional collaboration that improves health sustainability and patient outcomes.
CMS made funding awards to all 50 states:
| State | FY26 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 |
States will also convene annually at the CMS Rural Health Summit, to be held during the CMS Quality Conference in 2026, to share lessons learned, highlight effective models, and accelerate innovation across 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 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.
“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.”
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.
The program follows standard HHS grants policy, including protections that ensure the integrity of the merit review process, consistent with longstanding HHS practices for competitive grant and cooperative agreement programs. Check online for more information on the Rural Health Transformation Program.
