The Centers for Medicare & Medicaid Services on Monday awarded $10 billion to all 50 states for the second year of the Rural Health Transformation Program, according to reporting by Stateline outlets and Mississippi Today^1,6.

The five-year fund totals $50 billion, with $10 billion available each year through 2030, the reports said^1,5.

Texas received the largest fiscal 2027 grant, almost $282 million, followed by Alaska, Montana, California and Oklahoma^1,3,6.

Missouri was awarded $218 million, Maine more than $190 million, and Mississippi nearly $205 million — about $1.2 million less than Mississippi's first-year award, still above the average state award^3,5,6.

Half of each year's money is split equally, $100 million per state in baseline funds, with the rest based on rural population, facilities, state plans and other factors^1,4,6.

CMS said it reviewed first-year progress reports from all 50 states in setting this round^1,4.

Administrator Dr. Mehmet Oz said states have already put the money to work bringing care closer to home, according to a CMS news release quoted by the outlets^1,6.

Congress created the program after rural providers and lawmakers raised concern about Medicaid cuts in the tax-and-spending law President Donald Trump signed last year^1,6.

KFF estimated rural areas could lose about $137 billion in federal Medicaid spending over 10 years, the reports said, a figure larger than the transformation fund^1,6.

Rural healthcare leaders have said the grants are welcome but will not fully offset those cuts^1,4. CMS said states must use the grants to test approaches that can last after the five-year fund ends^1,5.

Mississippi Today reported that state Medicaid officials expect payment-rule changes to reduce net payments to Mississippi providers by about $100 million a year beginning in July 2028, and that the state had obligated more than $94 million in program funds as of July 31⁶.

Stateline reported that Democrats who won House and Senate majorities this month aim to repeal the underlying law, which would still need the president's signature^1,4.