The U.S. Department of Health and Human Services said Monday it awarded $10 billion to all 50 states for fiscal 2027, the second year of the Rural Health Transformation Program^1,2.

The five-year fund totals $50 billion, with $10 billion a year through 2030^1,2. With this round, HHS said $20 billion has been awarded and $30 billion remains¹.

Texas received the largest year-two grant, about $282 million, followed by Alaska, Montana, California and Oklahoma, according to the CMS table^1,2. New Jersey received the smallest amount, about $142 million^1,2.

Half of each year's money is split equally, $100 million in baseline funds per state, Stateline reporting carried by Arkansas Advocate said². The rest depends on rural population, facilities, applications and, CMS said, progress on approved plans, including some state policies such as the Presidential Fitness Test and nutrition continuing education for physicians^1,2.

CMS Administrator Mehmet Oz said, "States have already put these resources to work bringing better care closer to home"¹. HHS Secretary Robert F. Kennedy Jr. said the new awards would expand access, workforce and prevention with state flexibility¹.

Congress created the program amid concern over Medicaid reductions in last year's tax-and-spending law, Stateline and Mississippi Today reported^2,3. KFF estimates rural areas face about $137 billion in Medicaid losses, so the $50 billion fund would cover roughly a third of that, those outlets said^2,3.

The HHS release describes the authorizing law as passed by Republicans and opposed by Democrats¹. Stateline reported Democrats, after winning House and Senate majorities in this month's midterms, aim to repeal the law, which would still need President Donald Trump's signature².

Mississippi will receive about $205 million, roughly $1.2 million less than year one, Mississippi Today reported³. The state's Medicaid agency projects about $100 million a year less in net provider payments starting in July 2028³.

CMS said states must test approaches that can last after the five-year fund ends^1,2. How each state will spend the new round, and whether the grants offset Medicaid losses, remains unsettled on the public record^2,3.