House Speaker Mike Johnson (R-La.) on Tuesday praised the Trump administration and congressional Republicans for launching what he called the largest rural health investment in a generation following the Centers for Medicare and Medicaid Services (CMS) announcement of Fiscal Year 2026 awardees under the Rural Health Transformation Program.
“This week, Republicans are following through on our commitment to expand access to affordable, quality health care for patients living in rural America by awarding $50 billion spread across all 50 states that have long faced challenges delivering care,” Johnson stated.
He noted the program, established under the GOP’s Working Families Tax Cuts legislation, aims to expand access, support rural providers, develop a skilled workforce, drive innovation, and improve health outcomes. Johnson also criticized Democrats for “unsuccessfully attempting to repeal” the program earlier this year as part of negotiations to end what he characterized as their 43-day government shutdown.
CMS announced all 50 states will receive awards under the initiative—a $50 billion effort over five years to strengthen and modernize rural healthcare. States are expected to receive first-year awards in 2026 averaging approximately $200 million, ranging from roughly $147 million to $281 million.
Health and Human Services Secretary Robert F. Kennedy Jr. described the funding as placing “local hospitals, clinics, and health workers in control” while reducing bureaucratic barriers. CMS Administrator Dr. Mehmet Oz highlighted states’ “bold, creative plans” to expand rural access, modernize care, and support communities that keep the nation running.
The program targets rural areas where distance, provider shortages, and aging infrastructure often transform routine medical needs into life-threatening emergencies. State plans focus on expanding preventive, primary, maternal, and behavioral health services; strengthening emergency care through improved EMS coordination and “treat-in-place” options; and building workforce pipelines via training, recruitment incentives, and programs that help students start health careers locally.
Additional investments include facility upgrades, cybersecurity enhancements, telehealth expansion, remote patient monitoring, and digital tools to reduce clinician burdens. CMS also emphasized structural efficiency measures such as hub-and-spoke care networks and data-sharing platforms, alongside testing value-based care payment reforms.
Under the law, half of the funding is distributed equally among states, while the other half uses factors like rurality metrics and projected impact of state plans. Award totals vary significantly, with Texas receiving $281.3 million, Alaska $272.2 million, and New Jersey at the low end with $147.3 million. CMS stated funding will continue annually through 2030, with $10 billion available each year.
