Rural Health Policy Update

November 2023

Update provided by Andrew Coats, NOSORH Legislative Liaison 

As the calendar turns to November, the House resumes legislative work after weeks of turmoil. Number one on its To-Do list is funding the federal government ahead of the November 17 deadline. Congress averted a partial government shutdown by passing a continuing resolution (H.R. 5860) on September 30. The continuing resolution (CR) maintains federal funding at fiscal year (FY) 2023 levels through November 17.    

Newly elected Speaker of the House, Mike Johnson (R-LA) circulated a letter to Congress last week outlining his intent for the House to complete consideration of the eight remaining appropriation bills before the November 17 deadline and then enacting a CR that would run through mid-January or mid-April of 2024. The intent behind the delay is to allow the new Speaker time to settle in before attempting to pass an always contentious omnibus spending legislation.   

FY 2024 Appropriations Update: The CR buys Congress time to pass the Fiscal Year 2024 (FY 24) appropriation bills, which NOSORH is tracking. With a new Speaker of the House comes fresh concerns over the funding levels for rural health programs. Renewed calls for cuts in spending and offsets have been prominent in the days following Speaker Johnson’s ascent. As a reminder, below are the FY 24 funding levels for rural health programs that have been passed through the committee level in each chamber:    

Medicare Rural Hospital Flexibility program  

  • House:  $74,277,000 of that amount, $25,942,000 for the Small Rural Hospital Improvement Grant Program  
  • Senate: $64,277,000 of that amount, $20,942,000 for the Small Rural Hospital Improvement Grant 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 

    In October, NOSORH was in D.C. meeting with congressional offices on the importance of the RCORP program. NOSORH continues to push to get an RCORP authorization bill introduced in the Senate.   


    National Rural Health Day Approaching:  NOSORH will have a front-row seat to the FY 24 spending debate, as NOSORH will be in the halls of Congress to celebrate National Rural Health Day 2023. From 9:15-10:45 am on the morning of November 16, NOSORH is sponsoring a reception in 2044 Rayburn House Office Building that will spotlight the members of Congress and other rural health organizations who are dedicated to advancing rural health. The event will feature Republican and Democrat members of the newly formed House Rural Health Caucus, who will speak on rural health. For more information on this event, please contact Andrew Coats at