Research / Health & Human Services
Policy Analysis | November 2019
Federal Analysis: Rural Health Agenda
Rural hospitals have struggled to remain solvent in recent years. Since January 2010, 81 rural hospitals have closed in the SLC region. State and federal policy makers are working to mitigate this trend and promote the work of rural hospitals.* At the federal level, the recently introduced Rural Health Agenda offers potential assistance for rural hospitals and residents.
On July 31, 2019, U.S. Senator Marsha Blackburn (TN) introduced the Rural Health Agenda in the Senate to support the provision of rural healthcare. The agenda includes the Rural America Health Corps Act, Telehealth Across State Lines Act of 2019 and Rural Health Innovation Act of 2019. The three bills were each read twice and referred to the Senate’s Health, Education, Labor and Pensions Committee.
On October 29, 2019, U.S. Representative Phil Roe (TN) introduced companion bills for the Rural America Health Corps Act and Telehealth Across State Lines Act of 2019 in the House of Representatives. Both bills were referred to the House Energy and Commerce Committee; the latter was also referred to the Ways and Means Committee. That same day, U.S. Representative David Kustoff (TN) introduced a companion bill for the Rural Health Innovation Act of 2019, which was referred to the Energy and Commerce Committee.
The information provided is a summary of the three bills comprising the Rural Health Agenda. As the bills are in committee, they are subject to change. All information is current as of November 19, 2019.
Rural America Health Corps Act
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Response for Rural Hospitals: Here Today, Gone Tomorrow:
"I suspect many legislators, including myself, avoid healthcare issues because of their complexity. This research makes it feel more manageable. Wow, just wow! That was an amazing undertaking on the part of the SLC. Thanks for your hard work."
SLC Regional Resource | November 2019
Rural Hospitals: Here Today, Gone Tomorrow
With decreasing rural populations and changing federal regulations, many rural hospitals have struggled to maintain financial viability in recent years. In 2017, 6,210 total hospitals operated in the United States; 2,250, of these are rural hospitals. Nationally, 113 rural hospitals have closed since January 2010. Furthermore, the rate of rural hospital closures from 2013 to 2017 was twice as high as the rate of the previous five years. In January 2010, SLC member states had approximately 831 rural hospitals. Since then, 81 rural hospitals (9.7 percent) in the South have closed.
This SLC Regional Resource examines the unique circumstances facing rural hospitals and communities today, including healthcare regulations and recent federal actions aimed at directing greater financial support toward rural healthcare providers, followed by a review of legislation adopted in the 15 SLC member states addressing rural health, rural hospitals and their challenges.
Policy Analysis | August 2019
Approved 1115 Medicaid Demonstrations in the South
Under Section 1115 of the Social Security Act, the U.S. Department of Health and Human Services has the authority to waive specific provisions of major health and welfare programs, including Medicaid and the Children’s Health Insurance Program (CHIP). Section 1115 waivers give states the flexibility to implement experimental or pilot projects, frequently referred to as “demonstrations,” to test new approaches to Medicaid and CHIP that differ from federal rules. Approved demonstrations must be budget-neutral, meaning any changes to services or coverage cannot exceed existing costs. Additionally, all approved demonstrations are subject to specific rules regarding transparency and evaluation. Public notice and comment periods at both the state and federal levels are required before Section 1115 waivers are approved.1
In the SLC region, 10 states have approved Section 1115 waivers as of August 2019, for a total of 13 waivers (two each in Arkansas, Florida and Mississippi). Approved Southern state demonstrations focus on five key areas of Medicaid/CHIP services and coverage:
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SLC Human Services & Public Safety Committee
2019-2020
Chair
Senator
Katrina Shealy
South Carolina
2019-2020
Vice Chair
Representative
Fredrick J. Love
Arkansas
Immediate
Past Chair
(former) Senator
Doug Overbey
Tennessee
Ensuring the public’s general welfare and protection are among states’ most pressing concerns, with both areas constituting considerable shares of state budgets. The SLC Human Services & Public Safety Committee has a broad agenda, which takes into account the challenges states face in the areas of human services and corrections, as well as policies and programs that address them. The committee frequently undertakes assessments of pressing health issues including the national opioid crisis, organ donations and long-term care, as well as various corrections issues such as aging inmate populations, female offenders and mental health parity in prisons.
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