Oregon rural health gets $197M, but faces an annual Trump policy scorecard
BEND, Ore. (KTVZ) — A new $197.3 million federal award will help Oregon revamp health care in rural communities, but the state must navigate an annual review system that can claw back money if it falls short of Trump administration policy goals.
Funding tied to Trump policies
State funding for the Rural Health Transformation Program ranges from $145 million to $281 million. The program will distribute $50 billion over five fiscal years.
Half of the money is split evenly among states, and the other half is awarded through a point system based on a set of criteria. Of that discretionary half, about 20 percent is tied to a state’s commitment to specific policy actions, granting extra points to states that agree to implement Trump administration priorities.
States face annual re-scoring, with President Trump threatening to claw back funding from those that fail to meet the requirements.
Part of a $50 billion national program
The funding comes through the Rural Health Transformation Program, created under House Resolution 1, the federal budget reconciliation bill that became law in July 2025. The program will distribute $50 billion nationwide between 2026 and 2031, with individual state awards reviewed and adjusted annually, and OHA will work with federal officials in January to finalize Oregon’s program budget.
Investing in rural and Tribal health
OHA plans to invest the money in community‑driven projects that improve health care access, strengthen chronic disease management and prevention, grow and sustain the health care workforce, and expand health technology and data use in rural and frontier communities.
The Oregon Rural Health Transformation Program also includes a dedicated Tribal initiative providing direct funding to the Nine Federally Recognized Tribes in Oregon to improve health access and outcomes in ways that respect the government‑to‑government relationship.
State leaders promise careful stewardship
“Oregon is resolved to steward this funding effectively, ensuring it benefits rural communities across the entire state,” Governor Tina Kotek said, adding that the state looks forward to partnering with federal officials to advance rural health transformation. Clare Pierce‑Wrobel, OHA’s Health Policy & Analytics director, said OHA is honored to work with rural communities but cautioned that “this much‑needed boost can’t make up for the substantial federal funding cuts we anticipate in the coming years.”
Fast‑track awards in 2026
OHA plans to move quickly, making two rounds of awards in 2026 while standing up oversight and management structures to ensure fiscal stewardship and coordination with federal partners. Immediate Impact Awards will go first to strategic projects that can launch within two months of receiving money, followed by Catalyst Awards by mid‑2026 for ready‑to‑go projects selected through a formal application process that should open by spring.
In later years, further funding will be awarded competitively to projects focused on long‑term sustainability, shared infrastructure, and cross‑sector collaboration in rural health. Organizations interested in applying are encouraged to visit OHA’s Rural Health Transformation Program webpage for details and email updates.
