Big money's heading to rural America, and CMS is writing the checks. The Centers for Medicare & Medicaid Services just greenlit $50 billion over five years
for the Rural Health Transformation Program—all 50 states get a cut starting 2026. First-year awards average $200 million, ranging from New Jersey's $147 million to Texas grabbing $281 million. This comes from President Trump's Working Families Tax Cuts legislation. Dr. Mehmet Oz, CMS Administrator, put it straight: "This money is not there to pay bills... We want the money to be used to change the way we envision healthcare in rural America." HHS Secretary Robert F. Kennedy Jr. chimed in too, saying over 60 million rural folks deserve equal quality care without bureaucracy. States pitched bold plans—expanding clinics, training workers, upgrading tech—and CMS bought in across the board.
Today, @CMSGov announced that all 50 states will receive awards under the Rural Health Transformation Program, a $50 billion initiative established under the Working Families Tax Cuts legislation to strengthen and modernize health care in rural communities across the country.… pic.twitter.com/btt5fuCTn7
— DrOzCMS (@DrOzCMS) December 29, 2025
The program's no small potatoes. $10 billion drops yearly through 2030.
Bringing Care Closer To Home
Rural hospitals and clinics finally get breathing room. States plan to roll out preventive care, primary services, maternal health, and behavioral support right in communities. Think new access points, fitness programs, food-as-medicine pilots, and chronic disease prevention. Emergency response gets a lift too—better EMS comms, treat-in-place options, smoother transfers. Evidence-based stuff that hits root causes, not just symptoms.
Many states eye keeping strong local systems alive instead of folks driving hours for basics. Dr. Oz called it an "extraordinary milestone" with states stepping up creatively. Over 60 million rural Americans stand to benefit directly. This levels the playing field—urban polish meets rural reality.
Workforce And Tech Get Major Upgrades
No doctors, no care. States tackle that head-on with training, residencies, recruitment bonuses, and homegrown pipelines so local kids train and stay put. Upskilling current staff keeps experienced hands in the game. Tech side? Modernize facilities, beef up cybersecurity, push telehealth and remote monitoring. AI scribes and workflow tools cut clinician burnout. Hub-and-spoke models, regional excellence centers, data-sharing platforms—all aimed at local control over far-off decisions.
Value-based care pilots and payment reforms test fresh ideas for sustainability. Texas leads with $281 million, Alaska close at $272 million, California $233 million.
Oversight Ensures Real Change
CMS isn't just handing cash and walking. Each state gets a dedicated project officer for kickoffs, guidance, and progress checks. Annual updates track wins, spread best practices. States meet at the 2026 CMS Rural Health Summit during the Quality Conference to swap notes.
Applications went through rigorous merit review—experts in clinical ops, workforce, tech, payments scored them fairly, no conflicts. Half the funds split equal, half based on rural metrics, policies, impact potential per the Notice of Funding Opportunity. CMS site has full details at cms.gov/RHTProgram. This partnership aims for lasting fixes, not quick patches.
