Second-Year Rural Health Fund Awards Per Rural Resident Continue to Vary Widely Authors: Zachary Levinson and Scott Hulver Published: Nov 13, 2026

https://www.kff.org/medicaid/second-year-rural-health-fund-awards-per-rural-resident-continue-to-vary-widely/?utm_campaign=KFF-Health-Costs&utm_medium=email&_hsenc=p2ANqtz-8oDCdHs1LpbsgPcyCktID1Aw36wSS_4Ci4cEWroT5mBHucVnmrXjCaiG44m9rEmzVJfPtO9p5XyCyX0M6DPLwOveTLCw&_hsmi=449189078&utm_content=449189078&utm_source=hs_email Analysis: State Rural Health Fund Awards Don’t Closely Track Rural Populations The second-year awards to states under the federal Rural Health Transformation Program continue to show wide variation in how much money states receive per rural resident, a KFF analysis finds. Contact: Craig Palosky | 202.654.1369 | CraigP@kff.org The Centers for Medicaid and Medicare Services earlier this week awarded the second $10 billion batch in funding to states under the five-year, $50 billion program. Texas, which has more rural residents than any other state, received the largest second-year award of any state ($282 million) but the smallest payment per rural resident (about $70). This stems in part from the fact that half of the funds are shared equally among states while the rest is distributed based on other factors. In comparison, states like Rhode Island, New Jersey, and Alaska, with far fewer rural residents, received substantially higher amounts per rural resident (about $6,390, $1,030, and $990 respectively). The Rural Health Transformation Program was created under the July 2025 budget reconciliation law to help offset the impact of other health care changes in the bill, which was projected to reduce federal Medicaid spending by $911 billion over 10 years, including an estimated $137 billion reduction in rural areas.