Research by Nick Bowman


SLC Regional Resource | June 2021

Rural Hospitals During the COVID-19 Pandemic

Nick Bowman

Rural hospitals are a vital part of the U.S. healthcare sector and provide strong economic impacts. These healthcare facilities, which have an average of 25 inpatient beds, differ from urban hospitals in several ways. Many rural hospitals serve as the first point of care, sending patients to larger hospitals with more staff and medical equipment for specialized treatment. Due to their larger size and budgets, urban hospitals can offer a more comprehensive array of services. However, many rural hospitals perform just as well as urban hospitals and, in some cases, even outperform them.

Due to several factors, rural hospitals have struggled financially for years; 180 of them have closed since January 2005, with most closures in the South.* The reasons behind these closures include decreasing rural populations, changing federal healthcare regulations, and geographic isolation. A February 2019 report from Navigant, a Chicago-based consulting firm, found that 21 percent of U.S. rural hospitals were at high risk of closing unless their finances improve.

Since the emergence of COVID-19, Southern states have taken numerous measures in response to the pandemic. This SLC Regional Resource provides a summary of important state-level legislation related to rural hospitals and rural healthcare enacted between January 2020 and April 2021.


* For more on these issues, please see the November 2019 SLC Regional Resource, Rural Hospitals: Here Today, Gone Tomorrow.


Policy Analysis | April 2021

Coronavirus Impacts on State Legislatures: 2021

Mikko Lindberg, Roger Moore, Nick Bowman, Cody Allen, and Amanda Budd

Last updated: April 15, 2021

As of April 15, 2021, approximately 2.9 million people worldwide, including 548,000 Americans, have died from the coronavirus pandemic. On December 11, 2020, the U.S. Food and Drug Administration (FDA) approved an emergency use authorization for Pfizer/BioNTech’s coronavirus vaccine. On December 18, 2020, the FDA issued an emergency use authorization for the Moderna vaccine for use in individuals 18 or older. On February 27, 2021, the FDA issued an emergency use authorization for Johnson & Johnson’s single-dose vaccine. The Centers for Disease Control and Prevention (CDC) has developed a recommended schedule for states to administer these vaccines. As of April 15, approximately 123 million vaccinations have been administered in the United States. Against this backdrop, Southern legislatures are convening for their 2021 legislative sessions.

This SLC Policy Analysis, updated as new measures are implemented, tracks the special measures that Southern legislatures are adopting in order to meet safely in 2021.

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Policy Analysis | April 2021

Appropriations and Revenue Committee Structures in the South

Nick Bowman and Roger Moore

The appropriation of state funds through the budget and regulation of state revenue collections are two of the most critical tasks of state legislatures. The budget sets the state's goals and priorities for the next fiscal year or biennium, while tax rates ensure that the state has sufficient revenue to meet those goals. Consequently, legislative committees dedicated to appropriations and revenue have an essential role in this process. State legislatures have numerous structures for appropriations and revenue committees. Some chambers have an Appropriations Committee and a Ways and Means Committee, while others have multiple committees dedicated to separate appropriations categories. This report examines the different appropriations and revenue committee structures in the South.

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More Research by Nick Bowman


Webinar | September 2020

COVID-19 and American Agriculture

Policy Analysis | November 2019

Federal Analysis: Rural Health Agenda

SLC Regional Resource | November 2019

Rural Hospitals: Here Today, Gone Tomorrow

Policy Analysis | September 2019

Media Access at State Capitols

Policy Analysis | April 2019

Federal Legislation on Rural Hospitals

SLC Regional Resource | May 2018

Opioids and Organ Donations: A Tale of Two Crises

Policy Analysis | April 2018

Chamber Vote Adjustment in the South

Policy Analysis | September 2017

SLC Member State Revenue Increases

SLC Regional Resource | April 2017

Body-Worn Cameras: Laws and Policies in the South

Policy Analysis | November 2016

Outside Legal Counsel in SLC Member States

Policy Analysis | September 2016

Autonomous Vehicle Legislation and Trends