Rural Health Policy Update

April 2024

Update provided by Andrew Coats, NOSORH Legislative Liaison 

FY 2024 Spending Bill Signed into Law:   
In late March, President Biden signed into law the final Fiscal Year 2024 spending bill for federal agencies, including HHS. The $1.2 trillion bill finalized the funding levels for rural health programs through September 30, 2024. HRSA’s Federal Office of Rural Health Policy (FORHP) is funded at $364 million for FY24, included in that funding is: 

  • $12,500,000 for the State Offices of Rural Health (SORH) 
  • $64,277,000 million for the Medicare Rural Hospital Flexibility Program (Flex), including $21 million for the Small Rural Hospital Improvement (SHIP) grants.  
  • $145,000,000 for the Rural Communities Opioids Response Program (RCORP). This marks a $20 million increase over FY 23 levels.   
  • $12,700,000 for the Rural Residency Development Program 
  • $4,000,000 for the Rural Hospital Stabilization Pilot Program  

Also included in the omnibus package was $1.9 billion in discretionary funding for Community Health Centers (same as FY23). Congress also included an extension of the Conrad 30 waiver program, which lists certain foreign residency requirements for physicians with J-1 visas conditioned that they practice in a rural area for at least three years.   


FY 2025 Budget Request Released:   
With the FY 2024 appropriations process complete, the FY 2025 cycle continues to move forward in Congress. In mid-March, the Biden Administration released its fiscal year 2025 budget request to Congress. The request included the following proposals for rural health programs administered through FORHP: 

  • $64,277,000 million for the Medicare Rural Hospital Flexibility Grants Program, equal to the FY 24 enacted level. 
  • $12,500,000 for the SORH, equal to what was allocated in FY 24.   
  • $13 million for the Rural Residency Development Program. 
  • $145 million for RCORP, equal to the FY 24 enacted level.   
  • $11 million for the Rural Health Research and Policy Development Program.  

Throughout this year, NOSORH will seek to work with Congress to make them aware and updated on the SORH role in programs like Flex, SORH, and RCORP. Additionally, NOSORH will continue to seek increased funding for these programs.