States are moving at markedly different speeds to deploy billions of dollars in new federal funding for rural healthcare.
The $50 billion Rural Health Transformation Program was established under HR 1 and is administered by CMS, which will distribute $10 billion annually to all 50 states from 2026 through 2030. Each state designs and releases its own funding opportunities, meaning procurement timelines, program priorities and the pace at which money reaches local healthcare organizations vary widely from state to state.
The National Rural Health Association tracks each state’s procurement progress through a publicly available tracker that categorizes funding opportunities across four stages: anticipated, posted/open, in review and agreement/awarded.
As of August, every state has announced at least one funding opportunity, with Hawaii the only state still limited entirely to opportunities in the anticipated stage. Michigan leads all states with 12 awarded agreements, followed by Illinois (11 awarded), Delaware (nine awarded) and Georgia (eight awarded). Several states, including North Dakota, Vermont, West Virginia, Tennessee and South Dakota, have released 20 or more discrete funding opportunities spanning multiple program areas. Others, such as Connecticut and Massachusetts, have just one opportunity on record.
The table below represents data from the NRHA’s tracker, which was most recently updated Aug. 25. Total opportunities represent the number of discrete funding opportunities listed per state in the tracker; opportunities marked as closed are included in the count. The most advanced stage reflects the furthest a state has progressed in procurement, regardless of whether other opportunities remain in earlier stages. States with a diamond (◆) designation in the tracker have multiple opportunities in different stages simultaneously. States listed as “in development” have not yet announced any funding opportunities. Fiscal year 2026 award amounts are based on data from CMS.
The table is sorted by most advanced procurement stages, and states are listed alphabetically within each stage group. Data is subject to change; readers should consult the NRHA tracker directly for current status.
| State | FY 2026 award | Total opportunities | Most advanced stage |
| Alaska ◆ | $272 million | 7 | Agreement/Awarded (5 awarded) |
| Delaware ◆ | $157 million | 16 | Agreement/Awarded (9 awarded) |
| Florida | $210 million | 6 | Agreement/Awarded (6 awarded) |
| Georgia | $219 million | 8 | Agreement/Awarded (8 awarded) |
| Idaho ◆ | $186 million | 17 | Agreement/Awarded (2 awarded) |
| Illinois ◆ | $193 million | 12 | Agreement/Awarded (11 awarded) |
| Indiana ◆ | $207 million | 15 | Agreement/Awarded (6 awarded) |
| Iowa ◆ | $209 million | 10 | Agreement/Awarded (1 awarded) |
| Kansas ◆ | $222 million | 9 | Agreement/Awarded (3 awarded) |
| Massachusetts | $162 million | 1 | Agreement/Awarded (1 awarded) |
| Michigan ◆ | $173 million | 13 | Agreement/Awarded (12 awarded) |
| Missouri ◆ | $216 million | 7 | Agreement/Awarded (2 awarded) |
| Nebraska ◆ | $219 million | 14 | Agreement/Awarded (4 awarded) |
| Nevada ◆ | $180 million | 10 | Agreement/Awarded (1 awarded) |
| New Jersey | $147 million | 5 | Agreement/Awarded (5 awarded) |
| North Carolina ◆ | $213 million | 4 | Agreement/Awarded (2 awarded) |
| Ohio ◆ | $202 million | 12 | Agreement/Awarded (1 awarded) |
| Oklahoma ◆ | $223 million | 9 | Agreement/Awarded (2 awarded) |
| Oregon ◆ | $197 million | 5 | Agreement/Awarded (3 awarded) |
| South Carolina | $200 million | 5 | Agreement/Awarded (5 awarded) |
| South Dakota ◆ | $189 million | 21 | Agreement/Awarded (4 awarded) |
| Arizona ◆ | $167 million | 8 | Posted/Open |
| California ◆ | $234 million | 4 | Posted/Open |
| Maine ◆ | $190 million | 4 | Posted/Open |
| Maryland ◆ | $168 million | 16 | Posted/Open |
| Minnesota ◆ | $193 million | 19 | Posted/Open |
| New Hampshire ◆ | $204 million | 13 | Posted/Open |
| New Mexico ◆ | $211 million | 6 | Posted/Open |
| New York ◆ | $212 million | 4 | Posted/Open |
| North Dakota ◆ | $199 million | 25 | Posted/Open |
| Rhode Island ◆ | $156 million | 3 | Posted/Open |
| Tennessee ◆ | $207 million | 21 | Posted/Open |
| Texas ◆ | $281 million | 9 | Posted/Open |
| Utah ◆ | $196 million | 13 | Posted/Open |
| Virginia ◆ | $190 million | 14 | Posted/Open |
| West Virginia ◆ | $199 million | 26 | Posted/Open |
| Alabama | $203 million | 10 | In Review |
| Arkansas | $209 million | 4 | In Review |
| Colorado ◆ | $200 million | 2 | In Review |
| Connecticut | $154 million | 1 | In Review |
| Kentucky ◆ | $213 million | 10 | In Review |
| Louisiana | $208 million | 8 | In Review |
| Mississippi ◆ | $206 million | 8 | In Review |
| Montana | $234 million | 4 | In Review |
| Pennsylvania ◆ | $193 million | 11 | In Review |
| Vermont | $195 million | 27 | In Review |
| Washington | $181 million | 3 | In Review |
| Wisconsin | $204 million | 6 | In Review |
| Wyoming | $205 million | 9 | In Review |
| Hawaii | $189 million | 6 | Anticipated |
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