Rural Health Policy Update

August 2023

Appropriations: July saw both the House and Senate Labor-HHS appropriations bills for Fiscal Year 2024 (FY 24) advance through committee. The next stop for each will be passage before the full House and Senate. Below are the funding levels for the rural health programs from each chamber:  

  • Medicare Rural Hospital Flexibility program
    • House:  $74,277,000 of that amount, $25,942,000 for the Small Rural Hospital Improvement Program
    • Senate: $64,277,000 of that amount, $20,942,000 for the Small Rural Hospital Improvement Program
  • Rural Emergency Hospital Technical Assistance
    • House: $5,000,000
    • Senate: $5,000,000
  • State Offices of Rural Health grant program
    • House: $12,500,000
    • Senate: $12,500,000
  • Rural Residency Programs
    • House: $12,700,000
    • Senate: $12,500,000
  • Rural Communities Opioids Response Program  
    • House: $0
    • Senate: $155,000,000

The House bill allocates $147 billion to HHS, a 29 percent cut from FY 2023. Congress has until September 30, 2023, to reconcile the differences between the two chambers and pass a single funding bill into law. Given the extreme differences in funding amounts between the House and Senate, there will almost certainly be a 1-2 month funding extension for FY 23. Expect the FY 24 bill to be dealt with no earlier than late November, with a bill being signed into law in December. 

NOSORH on the Hill in July: NOSORH was in Washington D.C. during July, visiting with many House and Senate offices to discuss the importance of the Flex, SORH and RCORP programs. NOSORH had five in-person meetings, including with staff from the Senate Finance Committee. 

340B Program Comes Under Congressional Spotlight: The 340B Drug Discount Program (340B) has come under the spotlight of Congress this summer as part of a broader effort to increase transparency in health care. In May, the House Energy and Commerce Committee passed H.R. 3290, which would require 340B hospitals to report their total 340B savings annually, and other key metrics, including patient demographics and charity care information, to the Health Resources and Services Administration on top of other reporting requirements already in place for covered entities. In June, a group of six bipartisan Senators released a request for information to interested stakeholders seeking input on how to protect the integrity of the 340B program. Responses are due on July 28. 

Rural Health TA Bill Introduced: During July, Reps. Derek Kilmer (D-WA) and Jodey Arrington (R-TX) introduced the Rural Hospital Technical Assistance Program. The bipartisan legislation intends to protect and strengthen rural hospitals by making permanent a technical assistance program run by USDA for rural hospitals. 


Update provided by Andrew Coats, NOSORH Legislative Liaison