With $50 billion set to flow to states over the next five years, CMS’ new Rural Health Transformation Program represents one of the largest federal investments in rural healthcare in decades. However, experts believe that it will fall short of addressing the ongoing vulnerabilities that keep rural hospitals and clinics in such dire financial circumstances.

CMS’ new fund is part of the One Big Beautiful Bill Act , which was signed into law in July. Last month, the agency announced how the fund will work and invited states to apply.

The program will distribute $50 billion to states between fiscal year 2026 and fiscal year 2030, with $10 billion released each year. That represents roughly a 50% increase in federal spending on rural healthcare, which currently totals about $19 billion

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