Rural Health Policy Update

Update provided by Andrew Coats, NOSORH Legislative Liaison 

Authorization Update: On November 14, a bipartisan group of Senators introduced the Rural Hospital Flexibility Act of 2024, S. 5308, which seeks to reauthorize the Flex program. Here is the legislative text.  The bill was introduced by Senators Maggie Hassan (D-NH), Marsha Blackburn (R-TN, Catherine Cortez Masto (D-NV), and John Barrasso (R-WY). NOSORH has been working with these offices for over a year to get the bill introduced.  On November 21, Reps. Terri Sewell (D-AL) and Carol Miller (R-WV) introduced bipartisan legislation in the House.

National Rural Health Day Update: On November 21, Senator John Barrasso (R-WY) introduced S.Res.909, which supports the goals and ideals of National Rural Health Day (NRHD). The bipartisan Senate Resolution was supported by 31 Senators, an incredible showing of support for rural health. On the House side, Rep. Jill Tokuda (D-HI) and Rep. Diane Harshbarger (R-TN) introduced H.Res.1594, a companion measure to the Senate resolution. The bipartisan House Resolution was supported by 50 other House members. On the morning of November 13, NOSORH sponsored the 2nd annual “NRHD Celebration on the Hill” in the Senate. The breakfast reception was widely attended by industry, Senate staff, Senate committee staff, and HRSA, and even featured a stop-in from Senator Tina Smith (D-MN).  

Appropriations Update: Congress returned to session following the elections to finish up business for the 118th Congress. Congress currently has a December 20 deadline to fund the federal government for Fiscal Year (FY) 2025. The incoming Trump Administration is calculating whether to have Congress enact an FY 25 package in December or extend current FY 24 funding through March or September of 2025. It appears the incoming administration favors a three-month extension, which would make an omnibus spending package the first major legislative priority for the Trump Administration.     

Below are the FY 25 funding levels for rural health programs that have advanced out of the House and Senate Labor-HHS Appropriations Committees.

• Medicare Rural Hospital Flexibility program 
  – House FY 2025:  $74,277,000 of that amount, $25,942,000 for the Small Rural Hospital Improvement Program (SHIP) 
  – Senate FY 2025:  $64,277,000 of that amount, $40,942,000 for the SHIP
  – FY 2024 enacted:  $64,277,000 
• State Offices of Rural Health grant program 
  – House FY 2025: $13,500,000
  – Senate FY 2025:  $14,500,000
  -FY 2024 enacted:  $12,500,000 
• Rural Residency Planning and Development
  – House FY 2025:  $14,000,000
  – Senate FY 2025: $14,000,000
  – FY 2024 enacted:  $12,700,000 
• Rural Communities Opioids Response Program  
  – House FY 2025: $145,000,000
  – Senate FY 2025: $155,000,000
  – FY 2024 enacted:  $145,000,000