WASHINGTON, D.C.—NOVEMBER 9, 2026—The U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS) today announced $10 billion in awards to all 50 states for the second year of the Rural Health Transformation Program (RHTP), advancing President Trump’s historic $50 billion investment to transform rural healthcare across America. With implementation underway in every state, the second year of funding will help states build on early progress and deliver lasting improvements in access, quality, and health outcomes for rural Americans.
“President Trump made a historic investment in rural America, and HHS is putting those resources to work in every state,” said HHS Secretary Robert F. Kennedy, Jr. “This next $10 billion will expand access to care, strengthen the rural health workforce, improve prevention, and help states build solutions that fit the needs of their own communities. We are giving rural America the resources and flexibility to build stronger health systems that deliver better care and better outcomes.”
Today’s announcement builds on a year of implementation and investment in all 50 states. Across the country, states are turning their rural health transformation plans into action —establishing partnerships, launching initiatives, investing in equipment and technology, strengthening workforce pipelines, and putting resources to work in rural communities.
“Rural Americans have life expectancies three years shorter than their urban peers, but President Trump’s Rural Health Transformation Program is funding the historic investments necessary to close that gap,” said CMS Administrator Dr. Mehmet Oz. “States have already put these resources to work bringing better care closer to home for their rural communities, and CMS looks forward to helping them build on that progress in the coming year.”
In the second year, states will build on this momentum by advancing initiatives from their approved state-developed transformation plans. Depending on each state’s priorities, these initiatives may include efforts to improve prevention and chronic disease management, create sustainable access to care, strengthen the rural health workforce, advance innovative care and payment models, and put modern technology and data to work for rural patients and providers. Today’s funding will help states deepen implementation and build the capacity needed to sustain improvements over the long term.
This year’s awards also reflect, in part, states’ progress implementing their approved RHTP plans. All 50 states submitted annual reports documenting their progress, which CMS reviewed as part of determining each state’s award. State awards were determined based on a variety of factors, including state progress on implementation of state policies to improve rural health, such as the Presidential Fitness Test and Continuing Medical Education (CME) for physicians on nutrition. This annual review strengthens accountability for this historic federal investment and helps ensure taxpayer dollars continue supporting progress toward rural health transformation.
At the same time, the RHTP recognizes that meaningful transformation takes time and that states and rural communities begin from different starting points. The program’s five-year structure gives states the opportunity to build, test, refine, and scale approaches capable of delivering sustainable improvements beyond the life of the program.
States design and carry out strategies tailored to the needs of their rural communities, consistent with program requirements and their approved transformation plans. CMS’ Office of Rural Health Transformation works directly with each state, providing technical assistance, monitoring progress, and helping states translate their plans and investments into sustainable improvements in rural health.
Year 2 Rural Health Transformation Awards
| State | FY 2027 Award |
| Alabama | $199,278,801 |
| Alaska | $272,653,149 |
| Arizona | $165,014,474 |
| Arkansas | $207,788,910 |
| California | $231,105,823 |
| Colorado | $197,164,933 |
| Connecticut | $153,652,078 |
| Delaware | $160,294,521 |
| Florida | $203,828,071 |
| Georgia | $221,731,766 |
| Hawaii | $189,615,723 |
| Idaho | $182,698,377 |
| Illinois | $190,458,454 |
| Indiana | $208,908,591 |
| Iowa | $216,007,657 |
| Kansas | $225,896,117 |
| Kentucky | $211,330,599 |
| Louisiana | $211,858,378 |
| Maine | $190,358,993 |
| Maryland | $168,410,112 |
| Massachusetts | $158,392,692 |
| Michigan | $170,613,270 |
| Minnesota | $190,833,571 |
| Mississippi | $204,677,190 |
| Missouri | $218,547,090 |
| Montana | $239,740,669 |
| Nebraska | $219,247,775 |
| Nevada | $182,403,722 |
| New Hampshire | $204,312,551 |
| New Jersey | $142,338,224 |
| New Mexico | $211,044,635 |
| New York | $207,750,071 |
| North Carolina | $216,824,573 |
| North Dakota | $206,379,627 |
| Ohio | $201,926,470 |
| Oklahoma | $227,097,543 |
| Oregon | $197,254,520 |
| Pennsylvania | $190,730,492 |
| Rhode Island | $158,171,967 |
| South Carolina | $195,986,033 |
| South Dakota | $187,653,446 |
| Tennessee | $210,344,524 |
| Texas | $281,976,026 |
| Utah | $191,923,052 |
| Vermont | $189,996,036 |
| Virginia | $195,710,118 |
| Washington | $177,060,212 |
| West Virginia | $202,081,355 |
| Wisconsin | $203,695,089 |
| Wyoming | $207,231,931 |
Created through the Working Families Tax Cuts Act, RHTP is giving states unprecedented resources to transform how healthcare is delivered in rural communities. The legislation — passed by Republicans in Congress and unanimously opposed by Democrats — created a $50 billion, five-year investment to address longstanding challenges facing rural communities. Led by CMS, the RHTP is moving beyond the failed one-size-fits-all approach and giving rural communities the tools to build stronger, more innovative, and more sustainable health systems that deliver better care and better outcomes for the Americans they serve.
With today’s awards, the Trump Administration has now awarded $20 billion through the RHTP to support rural health transformation across all 50 states. Over the remaining three years of the program, an additional $30 billion will be awarded to support states as they continue implementing their transformation plans, demonstrating progress, and building stronger, more sustainable rural health systems. As states move from early implementation toward broader execution, CMS will continue working with them to address challenges and support sustainable approaches across rural America.
For a fact sheet about the RHTP and Year 2 awards, including how annual funding amounts are determined, visit: https://www.cms.gov/newsroom/fact-sheets/rural-health-transformation-program-year-2-awards.
Additional information about the RHTP, including state information, program guidance, and implementation resources, is available at: https://www.medicaid.gov/resources-for-states/rural-health.
