WASHINGTON, D.C. December 29, 2025 – The Trump administration has begun distributing funds from a historic $50 billion Rural Health Transformation Program, awarding grants to every state as part of efforts to modernize and strengthen healthcare in rural America.
White House Press Secretary Karoline Leavitt shared the announcement on X late Monday, linking to coverage of the initiative, which stems from the Working Families Tax Cuts legislation (also known as the One Big Beautiful Bill Act) passed earlier in 2025. The program allocates $10 billion annually over five years, from fiscal 2026 through 2030, with initial 2026 awards ranging from approximately $145 million to $281 million per state.
Centers for Medicare & Medicaid Services (CMS) Administrator Mehmet Oz emphasized that the funds aim to address longstanding disparities in rural healthcare, where ZIP codes increasingly predict life expectancy. “This is a massive effort to change the unfortunate reality that has overtaken rural healthcare in America,” Oz said during a briefing. The grants support expanding access to preventive, primary, maternal, and behavioral health services; bolstering rural workforces; streamlining operations; and testing innovative care models.
Half of the $50 billion is distributed equally among states, while the remainder is allocated based on rural population needs, existing infrastructure, state policy actions, and proposed initiatives. Officials noted that funds could be clawed back if states fail to meet commitments, prioritizing efficiency over new construction or bill payments.
The rollout follows concerns about Medicaid changes in the broader tax legislation, which critics estimated could reduce rural spending by over $100 billion. Supporters, including Health and Human Services Secretary Robert F. Kennedy Jr., hailed it as putting “local hospitals, clinics, and health workers in control of their communities’ healthcare.”
This development aligns with a teaser from senior trade adviser Peter Navarro, who on Monday stated, “Today’s the day where 50 states are going to find out,” in a video that garnered significant attention. The grants mark a major domestic investment amid the administration’s focus on rural communities, a key voter base.
Reactions on social media were mixed, with praise for bolstering rural access alongside skepticism over implementation and ties to broader healthcare reforms. The administration described the program as the largest targeted investment in rural health in U.S. history.
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