Rural Health Policy Update – August 2022

Appropriations: In July, the House passed a Fiscal Year 2023 “minibus” funding bill. The bill included funding for a number of federal agencies, including the FDA. The package did not include funding for HHS, which the House had targeted before the August recess but will now stretch into September.


The House Appropriations Labor-HHS Subcommittee released its draft FY 2023 spending bill in late June. The bill includes $12.5 million for the State Offices of Rural Health grant program ($12.5 million is the same as currently authorized). Also included in the House bill was $68 million for Medicare Rural Hospital Flexibility (Flex) grant program. If passed into law, this this would be an increase of almost $6 million from FY 22 funding ($62.2 million). Of this $68 million for Flex, $20.942 million would be for the Small Hospital Improvement Program (SHIP). And out of this amount, up to $5 million would be available for grants to public or non-profit entities for the Rural Emergency Hospital Technical Assistance program.


The Senate Appropriations Committee released their Labor-HHS FY 23 spending bill on July 28. Identical to the House, the Senate appropriated $12.5 million for the SORH grant program. This all but ensures the FY 2023 funding level for SORH grants will be $12.5 million once the bill is signed into law.


The Senate funded the Flex program at $62.2 million, and of that amount, SHIP would receive $20.942 million. The Senate Flex number is almost six million less than the House appropriated number, meaning the differences will have to be reconciled. As of this writing, no announcements have been made on committee markups. With only a handful of scheduled days with both the House and Senate in session together prior to the September 30 deadline, it is all but certain a Continuing Resolution (CR) will be in place through at least mid-to-late November of this year. The CR will maintain FY ’22 levels of funding.


SORH Reauthorization: During July, NOSORH met with the House Energy and Commerce Committee and Senate Health, Education, Labor and Pensions (HELP) Committee on the reauthorization of the SORH grant program. With SORH authorization expiring on September 30, 2022, NOSORH is pushing hard to get a bill through Congress to reauthorize the program.


Senate on the Brink of Passing Reconciliation Spending Bill: It appears Senate Democrats and the White House are close to passing a revised reconciliation package before its summer recess begins on August 8. Among other provisions, the package would require government health plans, including Medicare, to negotiate the prices of drugs with companies that produce them and limit seniors’ out-of-pocket costs to $2,000 per year. The deal would also extend ACA subsidies.