The White House’s senior aide announced on Monday, December 29th, that the Trump administration will launch a new rural healthcare transformation plan in 2026, allocating between $147 million and $281 million to each state in the United States with the aim of improving the access and quality of rural healthcare services.
This initiative is authorized under the “One Big Beautiful Bill Act” and is expected to provide a total of $50 billion in funding over five fiscal years. From the 2026 fiscal year to the 2030 fiscal year, $10 billion will be allocated annually.
Half of the funds will be divided among the states, while the remaining $25 billion will be distributed based on the current status of rural healthcare systems, state policy performance, and application proposals.
Mehmet Oz, the director of the Centers for Medicare & Medicaid Services (CMS), stated that this fund is designed to reverse the deterioration of rural healthcare systems.
He explained, “The $50 billion investment in rural healthcare is not intended to pay bills but to allow us to adjust the system scale and address the fundamental obstacles hindering rural healthcare improvement.”
He also warned that if states fail to meet improvement goals, the federal government will reclaim the funds. Bloomberg’s analysis suggests that this move strengthens federal control over local healthcare policies.
According to Reuters, the timing of the policy’s introduction is crucial. With the House of Representatives yet to extend the Affordable Care Act’s enhanced premium subsidies, many insured individuals in the healthcare market are expected to face premium increases starting January 1st.
Additionally, states are rushing to submit applications before the December 31st deadline. For example, Missouri is seeking to use this funding to alleviate the financial pressure caused by federal cuts to traditional Medicaid.
Data from the Pew Research Center shows that Trump has strong support among rural voters. In the 2024 presidential election, rural voters accounted for about 36% of his total voter base, while his Democratic opponent Kamala Harris had only 16% of rural voter support.