WASHINGTON—Under the budget cuts passed in the Republican-led House of Representatives last week, rural communities could lose $200 million in grants that help build accessible health care infrastructures, the Center for American Progress, a liberal think-tank, said Wednesday.
The group identified rural America as one of the top five groups that would be most affected by the House measure which drastically cuts overall federal spending for the reminder of the current fiscal year. The group said the cuts, which face an uphill battle in the Democratic controlled Senate, would affect more than 62 million Americans who live in rural communities.
The report came as the National Advisory Committee on Rural Health and Human Services opened its 67th annual meeting in Washington. The committee, made up of 25 health leaders representing various rural communities, advises HHS Secretary Kathleen Sebelius how to best deliver, research and develop health and human services in these areas.
The committee will examine how the health care reform law enacted last year affects rural communities, focusing on health insurance exchanges, home visitations for at risk mothers, infants and young children, and a new program to fund long term care with voluntary payroll deductions.
Last August HHS Secretary Kathleen Sebelius awarded $32 billion to support rural health priorities. But “comprehensive health reform is still needed to bring affordable, high quality health care to communities that need it the most,” she said in a statement earlier this year.
According to a study by the Rural Policy Research Institute, employers in rural areas tend to pay lower wages, hire fewer employees, and use insurance brokers—not employer-backed insurance companies which typically offer more benefits.
“This is why we need health insurance exchanges to provide comparable choices throughout the whole [national] market,” said Health Panel Chair Dr. Keith Mueller .
Mueller suggested health insurance exchanges, one-stop shops where consumers can choose the health care option that best suits them by comparing prices and benefits, would help address the problem.
The Obama administration touted the exchanges as part of the health care reform law enacted last March, arguing that they spread risks across a broader population, allowing consumers to pay lower premiums.
With few programs and thus far limited access to exchanges, rural communities have few options to choose, according to panel members.
Throughout the morning, speakers stressed the importance of stronger outreach programs to inform patients of their options. Some suggested creating a website and an 800- line people could call to learn more about exchanges offered locally, and said the language of health care information should be “adapted to participants’ education and skills.”
“Content only matters if people can relate to them,” said Jocelyn Richgels, a panel member.
“We don’t even understand all the acronyms,” said committee chair Ronnie Musgrove.
Other recommendations include less paperwork for grant applications to fund childcare programs and accessible transportation to clinics and hospitals.
Some panel members pointed out that the states share responsibility for implementing the law.
“I think we’re making recommendations, but at the end of the day, we [the states] can do whatever we want,” said member John Rockwood, Jr. “How far does the federal government go?”
Others said the federal government remains a driving force in improving rural health—especially since it subsidizes Medicare reimbursements.
“The government says, ‘If you don’t [regulate insurance], we will,’” said member Tom Hoyer, Jr.
Although the committee met to advise HHS on rural health policy, Secretary Sebelius did not attend the meeting. Members will draft recommendations for the Department. The next committee’s next conference will be held in Michigan this June.
Challenges in rural health infrastructure range from upgrading emergency medical services to increasing the availability of doctors.
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