Bipartisan proposal extends key Medicare rural hospital programs, builds on recent success
April 6, 2023 - WASHINGTON – Sens. Chuck Grassley (R-Iowa) and Bob Casey (D-Pa.) are continuing their support for rural health care by introducing the Rural Hospital 
Support Act. Their bipartisan proposal seeks to permanently extend two key Medicare rural hospital programs and establish a new rebasing year – preventing closures that would disrupt access to care for individuals in rural communities. The Rural Hospital Support Act would permanently extend the existing Medicare-dependent Hospital (MDH) and Low-Volume Hospital (LVH) programs, and it would establish a new rebasing year for Sole Community Hospitals (SCH) and MDHs based on 2016 data. Iowa is home to about a dozen hospitals that benefit from these programs.
John C. Fremont Hospital in Mariposa County
“As a resident of rural Iowa, I understand the importance of having access to health care services close to home. These programs bring a lot of value for rural residents and taxpayers,” Grassley said. “Small, rural hospitals offer good-quality health care at a cost that compares well with urban hospitals’ cost. Congress should permanently extend the programs that help keep the doors open for rural Medicare beneficiaries.”
“Every American deserves reliable access to health care,” Casey said. “Rural hospitals can be the difference between life and death in many parts of the U.S. Often, a rural hospital means not only safe, dependable access to health care and emergency health needs, but economic safety and stability for an entire community. This legislation takes an important step to maintain that lifeline, especially for older adults and lower income Americans. I will continue to work to bring federal funding to rural communities and make sure older Americans have the health care support they need no matter where they live.”
Additional Information
The bill’s original cosponsors include Senators Kaine (D-Virginia), Wicker (R-Miss.), Sinema (D-Arizona), Moran (R-Kansas), Smith (D-Minn.), Marshall (R-Kansas), Stabenow (D-Mich.), Boozman (R-Ark.), Heinrich (D-N.M.), Hawley (R-Missouri), Shaheen (D-N.H.), Capito (R-West Virginia.), and Kelly (D-Arizona).
Rural hospitals often provide care to patients who are older and have lower incomes compared to national averages, as well as patients who are more likely to rely on Medicare and Medicaid. In addition to being the main providers of care in their communities, many rural hospitals serve as economic anchors – accounting for around 14 percent of total employment in rural areas. Rural hospitals need predictable and stable resources to ensure that they can continue to serve their communities and provide quality care.
This effort builds off the recent two-year extension of the MDH and LVH through September 30, 2024. By helping hospitals keep their doors open, MDH and LVH designations are the safety net providers for rural Americans and are extremely important to rural economies. This legislation does not change other rural hospital Medicare programs including critical access hospitals (CAH), rural referral centers (RRC), Rural Community Hospital Demonstration, or the new voluntary rural emergency hospitals (REH). Each of these rural programs offer unique flexibilities to ensure health care services are accessible in rural America.
“These extender programs have an enormous financial impact on Iowa hospitals by providing funding for essential services and for hospitals to remain viable. These programs also allow hospitals to contribute to their communities through improvements to access to care, employing members of the community, and using services from community businesses, both in and outside of the healthcare sector. IHA is pleased to see Senator Grassley work on this important issue,” said Chris Mitchell, Iowa Hospital Association (IHA) President and Chief Executive Officer.
“The Low-Volume Hospital (LVH) program helps our rural community by providing necessary financial support to help ensure our patients and their families have health care that is accessible and affordable,” said Jenni Friedly, President of UnityPoint Health – Marshalltown.
“There is a continued need for small rural hospitals to help ensure Iowans living in rural communities have access to care locally. The Low-Volume Hospital (LVH) program will help continue to support this need and we appreciate Senator Grassley’s ongoing leadership in securing needed funding,” said Rachel Pohl, Executive Director of UnityPoint Health – Trinity Muscatine.
“MercyOne supports the Rural Hospital Support Act given our system includes hospitals of all different structures and sizes. For communities like Newton and Clinton, those local community hospitals are responsible for 24/7 coverage and have a critical responsibility to take care of Iowans. This legislation will help us to sustain community care 24/7, and ensure access to care across our state,” said Bob Ritz, President and Chief Executive Officer of MercyOne.
“The National Rural Health Association (NRHA) applauds Senators Chuck Grassley (R-IA) and Bob Casey (D-PA) for their bipartisan proposal to reauthorize the Medicare-Dependent Small Rural Hospital (MDH) and Low-Volume Hospital (LVH) program add-ons beyond October 1, 2024. Both the MDH and LVH designation are critical to providers across the United States. As rural America rebounds from the COVID-19 pandemic, now is not the time to let lifeline programs lapse. Reauthorization is critical to ensuring stability for the rural health safety net,” said Alan Morgan, Chief Executive Officer, National Rural Health Association.
“On behalf of our nearly 5,000 member hospitals, health systems and other health care organizations, our clinician partners — including more than 270,000 affiliated physicians, two million nurses and other caregivers — and the 43,000 health care leaders who belong to our professional membership groups, the American Hospital Association (AHA) is pleased to support the Rural Hospital Support Act (S. 1110),” said Lisa Kidder Hrobsky, Senior Vice President Advocacy and Political Affairs, American Hospital Association.
“Senators Casey and Grassley have long-recognized the challenges that rural hospitals face and the need for Congress to enact a long-term extension of these important payment protections. We thank the Senators, along with the bill’s 13 additional original cosponsors, for their commitment to safeguarding the ability of rural hospitals to serve their patients and communities,” Alliance for Rural Hospital Access.
Source: Senator Chuck Grassley
