Urban Health Transformation Act of 2026

The bill would appropriate $10 billion per year for fiscal years 2027 through 2031 for CMS to distribute to states with approved applications. States, the District of Columbia, and specified U.S. territories could apply, and states would not have to provide matching funds.

Each applicant would submit a plan to improve urban health care access and outcomes, address the risk of hospital closures or service cuts, and describe how it would use the funds. CMS would distribute half of each year’s funds equally among approved applicants and allocate the other half using factors including urban population and the number of urban health facilities.

States would have to use their grants for at least three listed activities, which include provider payments, prevention and chronic disease care, technology, recruiting and retaining clinicians, and mental health or substance use treatment. Clinicians recruited or retained with grant support would commit to serving urban communities for at least five years.

States could spend no more than 10% of their annual allotment on administrative expenses and would submit annual reports. CMS could withhold, reduce, or recover payments if a state used funds inconsistently with its approved application.

The bill would provide CMS $200 million for fiscal year 2026 to carry out the program; that funding would remain available until spent.