Texas Lawmakers Press the CMS for Fair Share of Rural Health Funds

Texas lawmakers are urging the Centers for Medicare & Medicaid Services (CMS) to ensure Texas receives a proportional share of newly available federal rural health funding.

Republican U.S. Senators Ted Cruz and John Cornyn, along with Rep. August Pfluger, led a letter to CMS Administrator Dr. Mehmet Oz supporting Texas's application to the Rural Health Transformation program, a $50 billion initiative created earlier this year under the One Big Beautiful Bill Act.

The lawmakers emphasized that Congress designed the program to give states flexibility in determining how the funds could best support rural health systems.

"As you know, Congress approved a historic investment in rural healthcare earlier this year by creating this program and ensuring that states can work with CMS to determine how to use these funds most effectively to meet the needs of their rural communities," the lawmakers wrote.

The letter warns that CMS's current distribution model could disproportionately disadvantage large rural states. Under the statutory directive, half of the $50 billion must be divided "equally among all states with approved application," regardless of the number of rural hospitals or the size of each state's rural population.

"Connecticut, which has three rural hospitals, could receive the same amount as Texas, which has 155 rural hospitals," said the Lawmakers.

Texas leaders argue that such an approach fails to reflect actual needs on the ground. They stressed that the state is prepared to "reach residents in 100% of Texas's rural counties and make rural Texans healthy again" by coordinating with rural hospitals, Federally Qualified Health Centers, and other providers.

The lawmakers urged CMS to "ensure an appropriate balance in funding distribution" that accounts for the scale and needs of Texas's rural communities.