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, after the Centers for Medicare and Medicaid Services (CMS) announced Fiscal Year 2026 awardees under the new 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 said in a statement emailed to Newsmax.
He said the program, created in the GOP's Working Families Tax Cuts legislation, was designed to expand access, support rural providers, develop a skilled workforce, drive innovation, and improve outcomes.
Johnson also took aim at Democrats, noting they "unsuccessfully attempted to repeal the program" earlier this year as part of negotiations to end what he described as their 43-day government shutdown.
CMS announced that all 50 states will receive awards under the initiative, a $50 billion effort to strengthen and modernize rural healthcare over five years.
CMS said states will receive first-year awards in 2026 averaging about $200 million, ranging from roughly $147 million to $281 million, with funding aimed at expanding access to care, strengthening the rural workforce, upgrading facilities and technology, and supporting new models that bring care closer to home.
Health and Human Services Secretary Robert F. Kennedy Jr. framed the awards as putting "local hospitals, clinics, and health workers in control" and reducing bureaucratic obstacles.
CMS Administrator Dr. Mehmet Oz said states are presenting "bold, creative plans" to expand rural access, modernize care, and support communities "that keep our nation running."
Conservatives have long argued that rural communities have been shortchanged by Washington policies that reward big-city systems while small-town hospitals struggle to keep doors open.
The new program, Republicans say, is a direct response — targeting resources to areas where distance, provider shortages, and aging infrastructure can turn routine medical needs into life-threatening emergencies.
CMS said state plans are expected to focus on several key priorities that include expanding preventive, primary, maternal, and behavioral health services; strengthening rural emergency care through improved EMS coordination and "treat-in-place" options; and building the workforce through training pipelines, residencies, recruitment incentives, and programs that help students start health careers close to home.
The agency also highlighted modernization efforts, including investments in facility upgrades, cybersecurity, interoperability, telehealth, remote patient monitoring, and digital tools that reduce clinician burdens.
CMS said states will also pursue structural efficiency — such as hub-and-spoke care networks and data-sharing platforms — and test value-based care and payment reforms.
Under the law, CMS said half of the funding is distributed equally among states, while the other half is allocated using factors such as rurality metrics and the projected impact of state plans.
Award totals vary widely, with Texas receiving $281.3 million, Alaska $272.2 million, and New Jersey at the low end with $147.3 million.
CMS said funding will continue annually through 2030, with $10 billion available each year.
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