Q&A: Federal Boost for Rural Health

Q: What is the Rural Health Transformation Fund?
A:Congress approved this summer a historic $50 billion federal investment to rebuild rural health infrastructure that was included in the health and tax bill President Trump signed into law on July 4. The Rural Health Transformation Fund is designed to help improve access to quality health care for Americans living in rural areas of the country. Beyond providing lifesaving services and a continuum of patient care, rural hospitals and clinics serve as an economic anchor and employer for the region. With fewer patients than their urban counterparts, many struggle to keep their doors open and keep providers on the payroll. Rural health care is an issue that comes up consistently at my annual 99 county meetings. As your senator, I work tirelessly to address Iowans’ concerns at the policymaking tables in Washington. For example, I’ve leveraged my seniority in the U.S. Senate to advocate on behalf of residents and health care providers across Iowa, from empowering localpharmaciststo provide essential health services and screenings toprotecting emergency servicesin rural areas.
Earlier this year, I introduced bipartisan legislation to prevent rural hospital closures by extending key federal programs I’ve championed for decades. MyRural Hospital Support Actwould permanently extend the Medicare-Dependent Hospital and Low-Volume Hospital programs to increase reimbursement for rural hospitals whose operating costs outpace their revenue. I have also introducedbipartisan legislationto address the maternal health care crisis in rural America through improving access to 21st century technology and community-based efforts. In May, following years of oversight, I welcomed action by the Centers for Medicare and Medicaid Services to fill 10 available spaces in itsRural Community Hospital Demonstrationprogram to give struggling hospitals a federal boost to help keep their doors open. These would be hospitals that are too large to qualify as a Critical Access Hospital and too small to benefit from Medicare’s prospective payment system. Four Iowa hospitals located in Fort Dodge, Grinnell, Newton and Spirit Lake are currently in the program.
Q: How will federal dollars in the Rural Health Transformation Fund be distributed?
A:Each state will receive at least $100 million each year for five years. The Centers for Medicare and Medicaid Services (CMS)will review applicationssubmitted by each state and also award additional funding based on state metrics to provide the best bang for the buck to improve services and tackle the root causes of poor health outcomes in rural communities. The new funding stream will empower local health care providers to innovate and tailor solutions to best fit the needs of their patients. Confronting systemic challenges, these dollars will help rural providers with expanded flexibility and resources to adopt technological innovation to manage chronic diseases, provide high quality treatments and preventative care to achieve better patient outcomes. In addition, the fund also will help recruit and retain a skilled health care workforce in local communities most in need, an issue I hear about frequently from civic leaders and health care providers in Iowa. This funding boost comes on top of the 2020 law I championed that is providing Iowa hospitals in Waterloo and the Des Moines area with Medicare funds to cover new graduate medical education (GME)residency positions in family medicine, emergency medicine, and cardiovascular disease.
Like many rural Americans, Iowans in some areas of the state face long travel times for care. That’s why I’ve worked to permanently expand flexibilities for telehealth services made available during the pandemic includingbehavioral and mental health services. The health law signed in July alsopermanently extends telehealth coverage for high-deductible health planswithout requiring patients to first meet their deductible, retroactive to Dec. 31, 2024, and improves access todirect primary care. I’ll continue pushing for Senate passage of my bipartisanCreating Opportunities Now for Necessary and Effective Care Technologies (CONNECT) for Health Actthat would make it easier for patients to connect with their doctors using telehealth.
Through my legislative and oversight work, I’ll keep close tabs on the new rural health program to ensure this federal funding stream operates efficiently and effectively. The deadline for states to apply is Nov. 5. CMS will announce the awards by Dec. 31.