The Rural Health Transformation Program is a five-year, $50 billion initiative that will provide $10 billion annually from 2026 to 2030 to all 50 US states to strengthen health care in rural areas.[1][3][6] Half of the funds will be divided equally among the approved states, and the other half according to factors such as the degree of rurality, the state of the health system, and proposed policies to improve access and quality of care.[1][2][6] First-year grants range from $147 million for New Jersey to $281 million for Texas.[3][6] States plan to fund infrastructure and technology upgrades, testing new primary and value-based care models, strengthening provider partnerships, and regional collaboration.[3][4] The program also supports recruitment and retention, telehealth, chronic disease prevention, and innovative payment models.[4][5] States must meet measurable goals and report results, meeting at the annual CMS Rural Health Summit in 2026.[1][3] The initiative is based on Public Law 119-21 and represents the largest federal investment in rural health in decades.[2][4] The program is intended to improve care for 60 million Americans living in rural areas.[3]