A Brief Commentary on Federal Action that Will Affect Health Care in Rural Communities

April

Lisa Davis, Director
Pennsylvania Office of Rural Health

Heath care continues to be front and center in discussions at the federal, state, and local levels and those who advocate for quality health care in rural communities need to remain current on those conversations. 

 The last half of 2011 was dominated at the federal level by the work of the Joint Select Committee on Deficit Reduction (aka the Super Committee). Pennsylvania Senator Pat Toomey’s role on the committee put the Keystone State front and center in the discussions. Programs supported by Medicare were especially vulnerable and included discussions about eliminating or significantly reducing the Medicare Rural Hospital Flexibility Program which lends support to the nation’s 1,300 Critical Access Hospitals and to other pro­grams that bolster health care delivery in rural areas. Rural health advocates from across the country made their voice known and those cuts were bypassed.

At the National Rural Health Association’s 2012 Policy Institute held in January in Washington, DC, rural health advocates heard unanimous consensus from federal legislators who pledged that rural America matters to Washington and that health care in rural areas is important.  The difference is how that support is organized and funded.  During the Institute, the House of Representatives’ Commerce Committee voted to repeal the CLASS (Community Living Assistance Services and Supports) portion of the Patient Protection and Affordability Care Act, paving the way for repeal of more portions of the Act.  During that week, the Senate formally proposed the Craig Thomas Rural Hospi­tal and Provider Equity (R-HoPE) Act of 2011 which includes a number of provisions that are important to rural health, notably payments to rural hospitals, health care providers, rural health clinics, and other components of the rural health delivery system; incentives for telehealth services, and the reauthorization of the State Office of Rural Health Program.  And the Supreme Court will be considering the repeal of the Affordable Care Act, beginning on March 26, 2012.

The work for the rural health community remains.  During the week of January 30, the Congressional Budget Office (CBO) released a report predicting that government spending for Medicare, Medicaid, and other health care programs will more than double over the next decade to $1.8 trillion.  Even under its most conservative projections, the CBO estimates that health care spending will rise by 8 percent a year from 2012 to 2022, mainly as a result of an aging population and rising treatment costs and will continue to be a key driver of the national budget deficit.  This means that programs that support rural health and the safety net system will continue to be under scrutiny; the focus on quality of care will continue to be emphasized; and health information technology implementation will be a driver of accessibility, quality, and cost of care.  Rural health advocates need to continue to make their voice heard.

Lisa Davis can be reached at (814) 863-8214 or lad3@psu.edu.

The Pennsylvania Office of Rural Health is one of 50 state offices of rural health in the nation charged with being a source of coordination, networking, and technical assistance.  The office is located at The Pennsylvania State University and is funded by the Health Resources and Services Administration in the U.S. Department of Health and Human Services, the Pennsylvania Department of Health, other state agencies, and Penn State.