WASHINGTON — President Donald Trump’s administration unveiled Monday hundreds of millions of dollars each state will receive this fiscal year as part of a massive $50 billion rural health fund baked into Republicans’ “big, beautiful” law.

The five-year Rural Health Transformation Program — authorized under GOP lawmakers’ mega tax and spending cut package Trump signed into law in July — is designed to offset the budget impacts on rural areas due to sweeping Medicaid cuts. 

Half of the $50 billion will be distributed equally among each state between fiscal years 2026 and 2030, according to the Centers for Medicare and Medicaid Services.

The agency under the U.S. Department of Health and Human Services said the remaining $25 billion, doled out over the same time period, is being allocated to states based on several factors, such as steps states are taking to improve access to care in rural communities.

Texas will get the highest first-year award at $281.3 million, followed by Alaska at $272.2 million, California at $233.6 million, Montana at $233.5 million and Oklahoma, at $223.5 million.

New Jersey is receiving the lowest first-year award, at $147.2 million.

“Thanks to Congress establishing this investment and President Trump for his leadership, states are stepping forward with bold, creative plans to expand rural access, strengthen their workforces, modernize care, and support the communities that keep our nation running,” CMS Administrator Dr. Mehmet Oz said in a statement alongside the announcement.

Oz added that “CMS is proud to partner with every state to turn their ideas into lasting improvements for rural families.”

Meanwhile, the nonpartisan health research organization KFF found that the program would only offset a little more than one-third of the package’s estimated $137 billion cut to federal Medicaid spending in rural areas over the next decade.

Nebraska’s Slice Of Fed Funds $218 Million

Nebraska Examiner

LINCOLN — Nebraska Gov. Jim Pillen said Monday that Nebraska secured the eighth-highest funding total in first-year rural health care improvement plan dollars from Congress’ tax and spending law President Donald Trump calls “big and beautiful.”

In Nebraska, the Pillen administration said in a statement it is aiming the funds announced by the federal Centers for Medicare and Medicaid Services at a sustainable model for rural care that embraces chronic disease prevention and applied technology.

“The partnerships we have built throughout President Trump’s team paid off for Nebraska today in a big way,” Pillen said. “The application I directed our team to submit for Rural Health Transformation funds was awarded over $218 million for rural healthcare.”

The funds included in the “One big, beautiful bill” are meant to offset negative impacts on rural hospitals and clinics facing congressional cuts to Medicaid over the next decade that could cost tens of thousands of rural Nebraskans their health coverage.

Independent researchers at the University of Nebraska Medical Center and elsewhere nationally have questioned whether the grant funding will be enough to offset the structural changes to Medicaid that narrow thin margins for medical providers in less populated areas.

Pillen and his team have pushed back on questions from the Nebraska Hospital Association and others about the fight over grant funding versus baseline funding by saying that the federal government aims to “modernize health care in rural communities.”

The Nebraskans argue the “Make America Health Again” agenda of Robert F. Kennedy Jr. and the federal Department of Health and Human Services will create more regional hubs for care and help fight obesity and related illnesses that spur many health care costs.

“President Trump’s commitment to rural economic revitalization is real, and today’s announcement is proof,” said Pillen, who lives and built his hog operation in Columbus in northeast Nebraska, in a rural community with Columbus Community Hospital.

Critics of the state’s new federal approach to funding rural care say it risks hastening losses of medical providers to larger communities like Grand Island, Kearney and Hastings and other cities on the Interstate 80 corridor, including North Platte, Lincoln and Omaha.

Pillen’s announcement says DHHS will combat this trend by spending money on addressing rural workforce gaps in nursing, physician assistants and doctors and improving access to specialists in more places using telemedicine and similar opportunities that expand reach.

Nebraska DHHS CEO Steve Corsi said in the announcement that the state intends to set a national example for investments in rural health infrastructure. National statements from Kennedy and federal CMS Administrator Dr. Mehmet Oz echoed his enthusiasm.

Nebraska’s all-GOP congressional delegation, including U.S. Sens. Deb Fischer and Pete Ricketts, have celebrated the funding as needed. Their support for the funds has been joined by Nebraska U.S. Reps. Mike Flood, Don Bacon and Adrian Smith.

— Aaron Sanderford

This story was published by Nebraska Examiner, an editorially independent newsroom providing a hard-hitting, daily flow of news. Read the original article: https://nebraskaexaminer.com/2025/12/30/repub/alaska-montana-oklahoma-cr...