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The Rural Health Impact of the President's FY 2015 Budget

President Obama's budget proposal, released earlier this morning, continues to be a source of concern for many rural health providers.  While the non-binding budget proposal is unlikely to be adopted by Congress, the President again proposes cuts to the Critical Access Hospital (CAH) system and other members of the rural health safety net.  As in years past, the President's proposal suggests cutting all CAH reimbursement from 101% of cost to 100% while completely excluding current CAHs that are within 10 miles of another health care facility, regardless of the care that other facility offers or who it is intended to serve.  Additionally, the budget proposal calls for additional cuts to bad debt reimbursement for all providers.  Even discretionary programs designed to help CAHs are being cut; the Rural Health Flexibility Grant line is cut by 15 million dollars. The President's proposal is not all bad, though.  As part of an effort to expand access to primary care providers, the President has proposed a significant investment in the National Health Service Corps (NHSC). In addition to nearly 310 million dollars in mandatory funding for the NHSC enacted as part of the Affordable Care Act (ACA), the budget asks for an additional 100 million dollars in FY 2015 to train more primary care providers to serve newly insured populations throughout rural America. Similarly, the Teaching Health Center program would continue to receive significant funding, as mandated by the ACA. While NRHA is appreciative of this funding, a number of other programs are targeted for cuts in the President's budget.  Area Health Education Centers would see their federal funding completely eliminated. A grant program designed to help rural communities acquire emergency medical devices would also be left without funds.  Taken in concert with the cuts proposed to CAHs, these sections of the President' budget would severely damage the rural health safety net.  NRHA will continue our efforts to ensure that these cuts are not enacted while working with the Administration and Congress to adequately train and retain a quality workforce in rural America.  If you have any questions, please contact NRHA Government Affairs Staff at (202) 639-0550.

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