Programs

On December 29, 2025, the Centers for Medicare and Medicaid Services (CMS) announced Rural Health Transformation Program (RHTP) funding awards for fiscal year 2026. This initial first-year distribution of awards to all 50 states within an annual range of $147- $281 million.

NRHA is proud to share our new Rural Health Transformation Program State Application Summary Guide to provide a picture of how states are designing and budgeting their initial transformation strategies. This guide serves as a resource on states’ intended use of RHTP funds. All information in this document is drawn from state applications and other publicly available sources. The proposals in these applications are pending CMS funding decisions that will be released no later than December 31, 2025.

The National Rural Health Association (NRHA) welcomes the release of the Rural Health Transformation Program Notice of Funding. This unprecedented federal investment in rural health directs $50 billion toward prevention, access, workforce, technology, and care innovation, mirroring NRHA’s priorities.

Medicaid serves as a vital source of health insurance coverage for Americans living in rural areas, including children, parents, seniors, individuals with disabilities, and pregnant women. The One Big Beautiful Bill Act (OBBBA), enacted into law on July 4, 2025 made sweeping changes to Medicaid and the ACA Marketplaces that will result in coverage losses for rural Americans.