Rural America a focus for bipartisan health caucus formed in U.S. House

By Samantha Dietel, Michigan Advance

A bipartisan congressional caucus aims to improve accessibility to quality health care and services in rural U.S. communities.

The Bipartisan Rural Health Caucus had its first meeting Sept. 20 and serves as a forum for U.S. representatives to promote legislation and policy actions regarding rural health. Members came together to discuss the issues their rural communities face.

There will be opportunities for members of the caucus to hear from patients, providers and health advocates about this issue, according to a press release from Rep. Mark Green, a Tennessee Republican. Carrie Cochran-McClain, chief policy officer of the National Rural Health Association, spoke at the first meeting.

The caucus will highlight potential policy solutions, including “stemming hospital closures, ensuring fair and adequate reimbursement rates, strengthening the health workforce, reducing health inequities and expanding telehealth and other innovative care delivery models” according to Green’s press release.

U.S. Reps. Jill Tokuda, a Hawaii Democrat, and Diana Harshbarger, a Tennessee Republican, serve as co-chairs of the caucus, which currently has 34 members made up of both Democrats and Republicans from across the country.

“A bunch of us decided it was time to pay closer attention to our rural communities, especially in terms of health,” Rep. Andrea Salinas, an Oregon Democrat and founding member of the caucus, told States Newsroom.

Harshbarger said that as a community pharmacist for over 30 years, she was proud to join this initiative “to highlight the needs of patients and health care professionals in rural and remote areas.”

“I look forward to working with my counterparts to address issues such as workforce shortages, supply scarcities, limited access to care and other health care challenges to improve patient outcomes,” Harshbarger said in a statement.

Struggling rural communities

Approximately 66.3 million people, or 20% of the national population, live in rural communities, according to the U.S. Census Bureau.

The COVID-19 pandemic brought greater attention to the obstacles rural communities face when it comes to health care. Many people in rural areas experience health care shortages and have to travel long distances to receive care.

“No one should have to travel for hours through treacherous terrain to see a doctor. But for so many in rural Oregon, this is simply reality,” Salinas said in a press release.

Salinas said that amid Oregon’s mental health and substance use crisis, “it’s even more critical that we address these issues now.”

Oregon’s 6th District, which Salinas represents, has experienced additional closures of health facilities in its rural areas, she said. Her district includes rural communities in Polk, Marion and Yamhill counties.

A medical center in Polk County, Oregon closed its maternity ward due to a shortage of obstetricians and gynecologists, Salinas said. Rural communities in Yamhill County also have a primary care physician shortage, she said.

Salinas’ district has the largest Latino population in Oregon, she said, and this community lacks the care they need.

“Mental health is a big issue for me, and I know in some of our rural counties, we don’t see the type of culturally and linguistically responsive care, especially when it comes to mental health care,” Salinas said.

Green emphasized in a statement the importance of removing barriers to emergency room care, as it “can mean life or death.”

“Tennessee is plagued by rural hospital closures and limited access to emergency medicine. This problem, combined with the second-most hospital closures of any other state, equals an impending disaster for my constituents,” Green said in a statement.

Bipartisan goals

Rep. Susan Wild, a Pennsylvania Democrat, said in a press release that she is excited to work with both her Democratic and Republican colleagues to address these barriers in rural America.

“Whether it’s advocating for fair reimbursement rates for rural hospitals, or pushing to protect the 340B drug pricing program, I’ll continue pushing to make sure that everyone — no matter where they live — can access the quality, affordable care they need to stay healthy,” Wild said.

Tokuda said Congress “must do more to target resources to address the health disparities in rural and remote communities.”

“From increasing mental health needs to expanding broadband to support telehealth and addressing provider shortages, it’s clear that while our districts vary in location and demographic, we are united in the fight to improve health care access,” Tokuda said in a press release.

Salinas said she is encouraged that so many representatives share a desire to combat the consequences of workforce shortages.

“I’m really hoping that we can work across the aisle because I’m consistently saying that the problems we’re seeing around mental health, substance use disorders, lack of access to primary care providers, reproductive care issues — it’s not just a CD6 in Oregon issue, it’s not just an Oregon issue, but it is a nationwide issue,” Salinas said.

Salinas said she is open to considering what red tape could be removed for health care providers. She referenced how during the pandemic, telehealth services offered people the ability to access health care providers from other states.

“So if you’re in a rural community, that really helped, but we also need to figure out the broadband issue,” Salinas said. “There’s so many other issues that go along with getting access to health care.”

Salinas said she hopes members of the caucus can find common ground on what the problems are and how to solve them.

“I’m just hoping to work with my colleagues on both sides of the aisle,” Salinas said, “so no matter who is in power in the House, whether it’s Democrats or Republicans, we can continue to move our rural communities forward.”