Rural health
This is another of those topics that is near and dear to me. Trump's Big Bad Bill has all but gutted funding for rural hospitals and clinics.
Suddenly, telehealth is not covered. Services provided by most rural hospitals and clinics will not be reimbursed under Medicare or Medicaid. Many mental health services provided by rural hospitals, clinics, and doctors will not be covered.
In October, when Medicare Advantage notices went out, there were several that notified us in Adams County, Pennsylvania, that they have withdrawn their MA plans for all rural counties in Pennsylvania.
Part of the issue: As it stands, Centers for Medicare and Medicaid Services (CMS) is the sole arbiter of what constitutes a rural hospital or clinic. There's no hard and fast cut-off.
While health and Medicare and Medicaid, and of course Social Security, tend to be highly partisan issues, you will see bipartisanship on rural health. It is scary that Congress is excluding those of us who live in rural areas from healthcare, at least what is covered by Medicare and Medicaid.
Highlighted legislation has bipartisan sponsorship.
Proposed legislation:
- October 10, 2025 – December 3, 2025: A Democratic bill supporting rural health made it through Committee and was referred to the House for a vote (not yet held); Rural Hospital Fairness Act carves out exceptions for critical hospitals and clinics harmed by Trump's BBB; establishment of a Rural Communities Opioid Response Program; and, a "pro-rural-health" resolution that a whole bunch of Republicans who will not support legislation put their names to.
- August 23, 2025 - October 9, 2025: Restoration of telehealth for rural areas (eliminated under Trump's BBB); requirement that rural areas have specific definition governed by Bureau of Census; allowing rural clinics and hospitals to provide mental health services; allow rural hospitals and clinics without a full-time physician on staff to qualify if they have 1+ physician assistants, or 1+ nurse practitioners. In other words, undoing the damage caused by Trump's BBB.
- July 17, 2025 - August 22, 2025: There is only one bill, to authorize a loan repayment program to encourage specialty medicine physicians to serve in rural communities experiencing a shortage of specialty medicine physicians. One Republican, four Democrats.