CMS awarded $10 billion to all 50 states Nov. 9 for the second year of the Rural Health Transformation Program, days after missing its Oct. 31 deadline to notify states of their 2027 allocations.
Fiscal year 2027 awards range from about $142.3 million for New Jersey to nearly $282 million for Texas. First-year awards ranged from $147 million to $281 million.
Each state receives $100 million in equal baseline funding each year. CMS distributes the other half of the annual $10 billion using factors that include rural population and facility characteristics, state policy actions and implementation progress. For year two, CMS reviewed states’ annual progress reports and weighed policies such as adoption of the Presidential Fitness Test and nutrition-focused continuing medical education for physicians.
“Rural Americans have life expectancies three years shorter than their urban peers, but President Trump’s Rural Health Transformation Program is funding the historic investments necessary to close that gap,” CMS Administrator Mehmet Oz, MD, said in a Nov. 9 news release.
CMS had alerted states to the delay in an Oct. 30 email from Alina Czekai, director of CMS’ Office of Rural Health Transformation, who wrote that officials had “discovered an additional administrative process requirement,” KFF Health News reported. State budget revisions tied to the new allocations are due to CMS by Nov. 30.
The second-year awards arrive as many rural hospitals are still waiting on first-year funding. Several rural hospital leaders told Becker’s in late October that state-approved projects have yet to be paid.
CMS has now awarded $20 billion through the program, which issues new allocations through FY 2030. All funds must be spent by Sept. 30, 2032, or returned to the U.S. Treasury.
Here are the FY 2027 awards by state:
| State | FY 2027 award |
| Alabama | $199,278,801 |
| Alaska | $272,653,149 |
| Arizona | $165,014,474 |
| Arkansas | $207,788,910 |
| California | $231,105,823 |
| Colorado | $197,164,933 |
| Connecticut | $153,652,078 |
| Delaware | $160,294,521 |
| Florida | $203,828,071 |
| Georgia | $221,731,766 |
| Hawaii | $189,615,723 |
| Idaho | $182,698,377 |
| Illinois | $190,458,454 |
| Indiana | $208,908,591 |
| Iowa | $216,007,657 |
| Kansas | $225,896,117 |
| Kentucky | $211,330,599 |
| Louisiana | $211,858,378 |
| Maine | $190,358,993 |
| Maryland | $168,410,112 |
| Massachusetts | $158,392,692 |
| Michigan | $170,613,270 |
| Minnesota | $190,833,571 |
| Mississippi | $204,677,190 |
| Missouri | $218,547,090 |
| Montana | $239,740,669 |
| Nebraska | $219,247,775 |
| Nevada | $182,403,722 |
| New Hampshire | $204,312,551 |
| New Jersey | $142,338,224 |
| New Mexico | $211,044,635 |
| New York | $207,750,071 |
| North Carolina | $216,824,573 |
| North Dakota | $206,379,627 |
| Ohio | $201,926,470 |
| Oklahoma | $227,097,543 |
| Oregon | $197,254,520 |
| Pennsylvania | $190,730,492 |
| Rhode Island | $158,171,967 |
| South Carolina | $195,986,033 |
| South Dakota | $187,653,446 |
| Tennessee | $210,344,524 |
| Texas | $281,976,026 |
| Utah | $191,923,052 |
| Vermont | $189,996,036 |
| Virginia | $195,710,118 |
| Washington | $177,060,212 |
| West Virginia | $202,081,355 |
| Wisconsin | $203,695,089 |
| Wyoming | $207,231,931 |
