Texas is slated to receive more than $1.4 billion in federal funding over the next five years through the Rural Health Transformation Program, a nationwide initiative designed to strengthen rural hospitals and clinics and expand access to care in underserved communities.
The program was authorized by Congress last summer and provides $50 billion in funding to all 50 states. Texas will receive approximately $281.3 million in the first year alone, the largest initial allocation awarded to any state. Overall, the funding averages about $281 million annually through 2030.
Despite receiving the highest total funding, Texas ranks last nationally in per-capita funding for rural residents, at roughly $60 per person. The lower per-person figure reflects the state’s large rural population. Nearly 80 percent of Texas’ 254 counties are considered rural, and more than half of the 82 health care facilities located in those counties are considered at risk of closure.
Under the program’s funding structure, half of the money is distributed evenly among states, while the remaining half is awarded using a scoring system that takes into account rural population size, state policy actions, and the quality of proposals submitted. Texas received about $81 million more than it requested during the first year of the program.
Texas’ proposal, titled Rural Texas Strong: Supporting Health and Wellness, outlines plans to strengthen rural hospitals, expand access to mental and physical health care, improve health care infrastructure, and support wellness, nutrition, and chronic disease prevention initiatives.
Gov. Greg Abbott said the funding will provide critical support to rural communities across the state.
“Rural Texans across the state will benefit from this historic federal investment. We will strengthen our rural hospitals, expand access to critical mental and physical health care, and help reduce chronic disease through wellness and nutrition initiatives,” Abbott said.
The funds will be administered by the Texas Health and Human Services Commission and are expected to support a range of efforts, including hospital stabilization, workforce recruitment, telehealth expansion, and modernization of rural health care systems.
State officials say the investment comes at a critical time, as many rural hospitals continue to face financial strain, staffing shortages, and increasing demand for services. While challenges remain, the funding is expected to provide a much-needed lifeline for rural communities and help preserve access to local health care across Texas.
