Graves bill aims to rescue America’s struggling rural hospitals

With 453 rural hospitals on the brink of closure, millions of Americans living in rural areas face losing access to the closest emergency room, one of several situations that U.S. Rep. Sam Graves (R-MO) proposes to address in his newly introduced bipartisan Save America’s Rural Hospitals Act.

“This isn’t a new problem. Our rural hospitals have been struggling to keep their doors open to patients for years,” Rep. Graves said. “But the COVID-19 pandemic has undoubtedly made this crisis worse, as many critical access hospitals are facing severe workforce shortages and skyrocketing expenses while reimbursement rates fall behind.”

Rep. Graves sponsored H.R. 6400 on Jan. 13 with original cosponsor U.S. Rep. Jared Huffman (D-CA) to amend the Social Security Act and provide for enhanced payments to rural healthcare providers under the Medicare and Medicaid programs, among other purposes, according to the text of the bill.

“This legislation reverses disastrous Medicare cuts that have hamstrung our rural hospitals for years and will help many of them get back on track,” said Rep. Graves. “There’s no better time to get this done.”

The text of the bill cites data from the University of North Carolina’s Cecil G. Sheps Center for Health Services Research showing that between January 2010 and Jan. 1, 2021, 137 rural hospitals closed in the United States and the rate of those closures is increasing.

Additionally, 453 hospitals are operating at margins similar to those that have closed over the past decade and of those, 216 are considered most vulnerable to closure, according to the bill. 

If enacted, H.R. 6400 would help reverse this trend by eliminating Medicare sequestration for rural hospitals; making Medicare telehealth service enhancements permanent for Federally Qualified Health Centers and Rural Health Clinics; and extending increased Medicare payments for rural ground ambulance services, according to a bill summary provided by Rep. Graves’ staff.

Among several other provisions, H.R. 6400 also would extend Medicaid Primary Care Payments; create reporting requirements for provider-based Rural Health Clinics; and reverse cuts to reimbursement of bad debt for critical access hospitals and rural hospitals, the summary says.

The National Organization of State Offices of Rural Health and the National Rural Health Association endorsed H.R. 6400, which has been referred for consideration to the U.S. House Energy and Commerce Committee, the U.S. House Ways and Means Committee, and the U.S. House Budget Committee.