The Centers for Medicare & Medicaid Services (CMS) on Dec. 29, 2025, announced that all 50 states received funding awards through the Rural Health Transformation Program (RHTP). The One Big Beautiful Bill Act (OBBBA, P.L. 119-21, PDF) authorized $50 billion for the program to address access to care issues for rural communities [refer to Washington Highlights, July 3, 2025]. States were required to submit applications to the agency by Nov. 5, with awards to be announced before the end of the year. Funding was made available to states starting Jan. 1, as required by the OBBBA.
Though every state received awards, funding was not evenly distributed among all 50 states due to how applications were scored — awards ranged between $147 million and $281 million for fiscal year 2026. As noted in the Notice of Funding Opportunity, states will not need to reapply for each of the five years of the RHTP, but funding may be reallocated if objectives are not met by states [refer to Washington Highlights, Sept. 19, 2025]. The CMS also shared that the CMS Rural Health Summit, held during the CMS Quality Conference in 2026, will convene states annually to share lessons learned from the program. More information on each state’s proposed projects and objectives can be found in the RHTP State Project Abstract (PDF)RHT Program State Project Abstracts Resource (PDF).