On Thursday, Congresswoman Terri Sewell, D-Alabama, and Congresswoman Carol Miller, R-West Virginia, introduced a new bill, the Rural Hospital Flexibility Act of 2024, which would increase the ability of the federal government to issue grants to state programs supporting critical access hospitals and rural emergency hospitals.
Most critical access hospitals are over 35 miles from any other hospital and they are required to “[make] available 24-hour emergency care services” in rural areas.
The bill would also appropriate “such sums as may be necessary” for the Rural Hospital Flexibility Program to issue needed grants without any explicit expiration date.
Sewell and Miller have jointly proposed several healthcare bills in the past, including the Assistance for Rural Community Hospitals Act and the Kidney PATIENT Act.
“At a time when Alabama’s rural hospitals are facing enormous financial challenges, we must do all we can to ensure that patients in rural communities can access the lifesaving services they need,” Sewell said in a public statement announcing the new legislation.
“Reauthorizing the Rural Hospital Flexibility Program will help Critical Access Hospitals in Alabama keep their doors open and improve the quality of care they deliver to patients,” she continued. “I thank Congresswoman Miller for her partnership and urge my colleagues to join us in supporting this legislation.”
Miller explained that the bill “will reauthorize the Medicare Rural Hospital Flexibility Program so these hospitals continue to receive funding from states to further improve their health care systems and care for their patients.”
Alabama currently has eight critical access hospitals, including ones in Wedowee, Butler, and Oneonta. The lack of quality healthcare in rural parts of the state has been a persistent problem, with different reports drawing attention to lack of access to dental care and to maternal care.
Hospitals across the state have also been experiencing significant financial distress in recent years, with several closing their doors or significantly decreasing the services they provide. Most recently, Jackson Hospital in Montgomery began a financial restructuring.
Several organizations and individuals have attributed the plight of Alabama hospitals, especially rural hospitals, to state politicians’ continued refusal to expand Medicaid, or to otherwise help provide health insurance to poor Alabamians. One of the many factors that led to the failure of the gambling legalization bills during the last state legislative session was a provision which would have used gambling tax revenue to help close the healthcare gap.
Shomari Figures, the Congressman-elect who will be representing Alabama’s 2nd Congressional District, made expanding Medicaid one of the central planks of his campaign. (However, he is unlikely to be able to do much on this front once in Congress: expanding Medicaid would require action in the state legislature and the governor’s mansion.)
And Justin Bogie, the senior director of fiscal policy at the Alabama Policy Institute, a conservative think-tank, maintains that expanding Medicaid “might do little to decrease the strain on health care providers in those areas.” Instead, Bogie argues, Alabama really needs to reform its Certificate of Need program.
No one expects the Rural Hospital Flexibility Act, if passed, to reverse the troubling trends in Alabama healthcare, but its supporters say it could help keep critical access hospitals afloat and encourage them to become rural emergency hospitals.
Alan Morgan, CEO of the nonprofit National Rural Health Association, stated that the program the bill would extend “is instrumental in serving Critical Access Hospitals across the country and ensuring they are able to support the health needs of their communities.”
