Idaho Receives $182.7 Million in Second Rural Health Grant Year

Idaho will receive about $182.7 million in the second year of the federal Rural Health Transformation grant program, an award below the nearly $186 million the state received for the program’s first year.

Congress established the five-year program through the 2025 One Big Beautiful Bill Act, allocating $50 billion nationwide. The program was created alongside an estimated $1 trillion reduction in Medicaid spending over 10 years, with those reductions beginning Jan. 1, 2027.

Idaho’s First-Year Projects

Idaho received its initial award on Dec. 30, 2025, and state and federal authorities announced Oct. 28 that all first-year money had been assigned to rural health projects.

Those projects included improvements to rural hospital facilities, emergency medical equipment, workforce development and mobile clinics. Gov. Brad Little said, “Where you live should not determine whether you can access quality, affordable health care.”

Competitive Grant Formula

The second-year announcement had been planned for Oct. 31, but states were notified Oct. 30 that it would be delayed. States submitted progress reports by Sept. 30, which helped determine the second-year awards.

Funding is split between an equal allocation for states and a competitive component. The competitive review considers state initiatives, rural-population characteristics, health-care facilities, policy alignment and other program requirements.

Idaho ranked No. 40 among state grant amounts. Idaho Department of Health and Welfare Director Juliet Charron said Idaho’s lower first-year score was tied to the state’s low population density and relatively low density of rural health-care providers.

State Awards Vary

Texas received the largest second-year award, at nearly $282 million. Alaska received the second-largest amount, $272.6 million, while Montana received the third-highest award at $239.7 million.

New Jersey received the smallest award, $142.3 million. Health and Human Services Secretary Robert F. Kennedy Jr. said the next $10 billion would support care access, rural workforce capacity, prevention and state-designed approaches for local communities.