NRHA Statement on Energy & Commerce Reconciliation Bill

The National Rural Health Association released the following statement in response to legislation from the House Energy and Commerce Committee:

"Legislation from the House Energy and Commerce Committee proposes changes to Medicaid that will result in massive coverage losses and will further stifle access to care for all rural patients by closing rural facilities and ending health care coverage for rural residents nationwide. The National Rural Health Association (NRHA) is extremely concerned by the Committee’s efforts to limit enrollees’ access to health care coverage through constraining states’ use of provider taxes and state directed payments, work requirements, more frequent eligibility redeterminations, and limiting retroactive coverage.

The Congressional Budget Office (CBO) estimates that the proposals will result in monumental Medicaid coverage losses and an increase in the uninsured population, amounting to 8.6 million individuals without coverage. While these options may reduce the federal deficit, rural patients will pay more in the long term because they cannot afford preventive care without Medicaid coverage, thus ultimately driving up costs to the larger rural health care system through increased emergency department use and uncompensated care.

Medicaid is more than just health care coverage in rural communities – it plays a significant role in sustaining the viability of rural health care systems, including hospitals, clinics, long-term care, and community health centers. Rural areas will suffer the most if these policies are enacted as rural residents rely upon Medicaid for health care coverage more than their urban counterparts, and public payers, including Medicaid, comprise a larger share of rural hospital services. Drastic cuts, such as those proposed by the Energy and Commerce Committee, will force many rural facilities to reduce or cut service lines or close their doors entirely, impacting access to care for everyone who lives in in the community.

NRHA urges Congress to reject cuts to the Medicaid program and protect rural health care."