Montana Set to Receive $233 Million Through Federal Rural Healthcare Program
The Centers for Medicare and Medicaid Services awarded the Treasure State the fourth largest grant out of all 50 states that applied for the Rural Health Transformation Program
By Zoë Buhrmaster
A federal healthcare program from The Centers for Medicare and Medicaid Services (CMS) is providing states with $50 billion spread out over the next five years to improve access and quality in rural healthcare.
Passed inside of the One Big Beautiful Bill Act, the Rural Health Transformation Program (RHTP) will distribute 50% of its funds equally among all states with an approved application. The other 50% is allocated based on the size of a state’s rural population and how the proposed plans line up with CMS criteria.
CMS announced the first year of RHTP grants Monday, with Montana receiving $233 million for 2026. Of all 50 states that applied, Montana will receive the fourth largest grant — only about $130,000 less than California, which has a population more than 30 times the size of Montana’s.
State Rep. Ed Buttrey, R-Great Falls, who carried legislation to extend Medicaid in Montana and currently serves as the president for the Montana Hospital Association, pointed to the quality of state’s proposed plan as well as the scale of its rural healthcare needs.
“This award reflects the strength of the Gianforte Administration’s proposal on behalf of Montana’s rural communities and healthcare providers,” Buttrey said in a press release. “Montana’s award is the fourth highest in the nation, underscoring both the scale of rural health challenges in our state and the quality of Montana’s proposal.”
Montana health officials submitted the state’s application in November. Under the tight seven-week application development timeline, state health officials met with hospitals, rural health stakeholders, all eight tribal nations and Urban Indian Organizations, and other government agencies to develop a plan.
The state’s RHTP plan includes five project goals: developing a rural health workforce, improving healthcare access points, refining care coordination, promoting community-based prevention, and expanding technology in rural healthcare systems. The goals largely follow CMS criteria laying out the same five strategic objectives.
Nearly 50% of Montana’s population lives in entirely rural counties, and an additional 12% live in rural census tracks, according to the state Department of Public Health and Human Services.
“With this unprecedented funding, we are taking a major step toward modernizing Montana’s rural health care systems,” Gov. Greg Gianforte said. “Thanks to President Trump, we’re launching this program and making a long-term commitment to our rural communities by providing Montana families with the access to health care they deserve.”
Montana’s congressional delegates held up the RHTP initiative as a strategy to improve access to rural healthcare systems, which in recent months have confronted other obstacles as a result of Trump’s budget reconciliation bill, also called the Working Families Tact Cut Act, including steep cuts to Medicaid. also praised the RHTP funding as a way to improve access to rural healthcare.
“Today’s historic investment in rural health care is a direct result of President Trump’s Working Families Tax Cut and is the largest investment of its kind in history,” Daines said in a prepared statement on Monday. “It’s a massive win for Montana — thank you President Trump!”