Rural Texas Strong Revised Budget
The Health and Human Services Commission (HHSC) submitted budget revisions for federal funding to implement the Rural Texas Strong program. The Centers for Medicare and Medicaid Services (CMS) required states to submit updated budgets by January 30. HHSC has revised the following materials to account for the increased award amount from the proposed $200 million to $281.3 million in Budget Period 1.
Once CMS approves the Rural Texas Strong budget, HHSC can advance its implementation of the six RTS Initiatives it proposed in its application for federal funding.
The Rural Texas Strong (RTS) program is the name of Texas’ program at the Health and Human Services Commission (HHSC) that will implement and distribute the federal funding. The six initiatives identify how Texas will use RHT funding to invest in rural health care and improve health outcomes for rural Texans and are described in the project narrative in the Texas RHT application. The initiatives were created based on input from stakeholders to HHSC during the RHT application period.
Background
The federal Rural Health Transformation (RHT) program was authorized by the Working Families Tax Cuts legislation (Section 71401 of Public Law 119-21) and previously known as the One Big Beautiful Bill Act to empower states to strengthen rural communities across the country by improving healthcare access, quality, and outcomes by transforming the healthcare delivery ecosystem. To qualify for funding, states had to apply by November 5, 2025. On behalf of the state, HHSC submitted an application entitled Rural Texas Strong. On December 29, 2025, CMS awarded Texas $281.3 million for the first year of the 5-year RHT program.
Stevens Amendment
HHSC is required by CMS to include the Stevens Amendment language below which acknowledges the federal support for the Rural Texas Strong program.
Rural Texas Strong, is supported by CMS of the U.S. Department of Health and Human Services (HHS) as part of a financial assistance award with 100 percent of funding by CMS/HHS. The contents of this email are those of HHSC and do not necessarily represent the official views of, nor an endorsement, by CMS/HHS, or the U.S. Government.
Questions
For questions about the Rural Texas Strong Program and federal Rural Health Transformation funding, contact HHSC Rural Texas Strong. To receive email updates from HHSC, please sign up here.
Learn more about Rural Texas Strong and Rural Health Transformation Funding.
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