Q&A: Rural Health on the Front Burner

Q: What rural health policy are you pushing to get to the president’s desk yet this year? A: As Iowa’s U.S. Senator, I’ve leveraged my committee assignments to help keep healthcare close to home for rural communities across our state. As then-chairman of the Senate Finance Committee, I led efforts more than two decades ago to create a federal program to boost financial viability of rural hospitals that I referred to as “tweeners.” These hospitals fell through the cracks of Medicare’s payment system and they didn’t benefit from patient volume in larger urban systems or regional referral hospitals. And yet, these “tweener” hospitals provide primary and emergency healthcare services across rural economic corridors impacting thousands of residents, workers, farmers and families in their respective regions. With passage of the Rural Community Hospital Demonstration program in 2003, my advocacy secured fairness from Medicare’s payment formula and recognized the contribution these hospitals have in our healthcare delivery system, in addition to their influence as major employers and social fabric of their respective communities. The program has been reauthorized three times. By all accounts, it’s provided a financial lifeline to rural hospitals across the country. Currently, four Iowa hospitals participate, including in Fort Dodge, Grinnell, Newton and Spirit Lake. These rural hospitals serve more than their rural communities. In Iowa , these communities are summer vacation destinations, home to county fairs and a NASCAR race and the site of a nationally recognized college. Up to 30 hospitals may qualify for this federal program and I led the charge to make sure the Centers for Medicare and Medicaid Services didn’t leave eligible hospitals behind. At my urging, the Trump administration filled 10 available spaces in this program. Most recently, I’m leading a bipartisan coalition in the U.S. Senate to enact the Rural Community Hospital Demonstration Reauthorization Act that would extend the program for another five years. For participating hospitals, the innovative Medicare payment model has a proven track record of provider recruitment and retention, facility and technology upgrades and keeping healthcare services close to home. The Senate unanimously passed my bill in May and I’m pushing to get it to the president’s desk this year. Q : How did Iowa fare in the second round of awards from the Rural Health Transformation Fund? A: The Working Families Tax Cuts Act included a historic investment in rural healthcare called the Rural Health Transformation Fund. The $50 billion fund will be distributed to the 50 states over five years to strengthen hospitals, clinics and other rural providers to improve care for local residents. The second installment of money announced by the U.S. Department of Health and Human Services is welcome news for Iowa, building on last year’s award of $209 million. Iowa will receive $216 million in 2027 to support the Healthy Hometowns initiative launched by Gov. Kim Reynolds. I called upon the Trump administration throughout the year to support Iowa’s progress to improve care in rural communities. During my annual 99 county meetings, I learned firsthand how these federal dollars support healthcare services in local communities across our state. From Cass to Kossuth , Mahaska , Poweshiek and Webster counties, the Rural Health Transformation program is helping improve the quality of life and health outcomes for Iowans. From expanding cancer screening and treatment – as well as maternal health and telehealth access – to boosting workforce recruitment and retention, improving mobile Emergency Medical Services (EMS) and coordinating services among specialty providers, I look forward to seeing how local hospitals and providers capitalize on this federal investment for Iowans in the year ahead.