Bill Overview
Title: Rural HELP Act of 2022
Description: This bill makes certain payment adjustments for Medicare-dependent hospitals and low-volume hospitals permanent (the adjustments currently expire at the end of FY2022).
Sponsors: Rep. Graves, Sam [R-MO-6]
Target Audience
Population: People dependent on rural and low-volume hospitals
Estimated Size: 10000000
- The bill is titled the Rural HELP Act, which indicates a focus on rural areas.
- The legislation addresses payment adjustments for Medicare-dependent hospitals.
- Medicare-dependent hospitals are those where a significant portion of funding comes from Medicare reimbursements, often in rural areas.
- Low-volume hospitals, which are also targeted by this bill, typically serve communities with lower population densities.
- Rural areas in general have a significant portion of their population who are dependent on hospital services as a direct employment source or healthcare provider.
- The global population of rural areas that could use Medicare-dependent and low-volume hospitals can include millions globally.
Reasoning
- The Rural HELP Act targets rural and low-volume hospitals, which means the direct beneficiaries will be populations in rural areas relying on these hospitals for medical care.
- Populations particularly affected include older adults on Medicare and individuals with limited access to healthcare facilities due to geographic constraints.
- Given budget constraints, the policy will not revolutionize rural healthcare overnight, but aims to provide financial stability and sustainability to crucial rural health infrastructures.
- The sustained funding should help maintain services in hospitals that might otherwise face financial difficulties, indirectly supporting both access to healthcare and local employment.
- We also considered that not all rural individuals will be directly impacted—only those who rely on these specific hospitals would see a change in service stability.
- Finally, understanding the broader implications of hospital staffing, emergency services, and overall community health outcomes were essential to select the perspectives presented here.
Simulated Interviews
Retired school teacher (Pinedale, Wyoming)
Age: 70 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 12/20
Statement of Opinion:
- Rural hospitals are crucial for my health needs, especially as I've become less mobile.
- It concerns me whenever there's talk about hospitals having to cut services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 2 |
Cattle rancher (Buffalo, Texas)
Age: 45 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- I'm worried about if an emergency were to happen, it's a long way to the next nearest hospital.
- Keeping our local hospital running is key for our community.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 3 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 5 | 2 |
Hospital administrative assistant (Tazewell, Virginia)
Age: 60 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- The stability of my job is crucial, and this policy makes me hopeful we can continue operating as usual.
- I've seen services cut in similar hospitals, which can be devastating for people here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 8 | 4 |
| Year 3 | 8 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 3 |
| Year 20 | 6 | 2 |
Paramedic (Fort Scott, Kansas)
Age: 30 | Gender: male
Wellbeing Before Policy: 7
Duration of Impact: 5.0 years
Commonness: 9/20
Statement of Opinion:
- More secure hospital funding means we can get people the help they need locally and quickly.
- I support any legislative effort that helps us do our jobs better in saving lives.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 6 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 5 |
| Year 20 | 6 | 5 |
Retired mining engineer (Elko, Nevada)
Age: 66 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 11/20
Statement of Opinion:
- I rely on our hospital for a lot, including managing my health.
- Medicare-dependent hospitals are often all we have, and losing any services would be hard.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 3 |
| Year 20 | 5 | 2 |
Farmer (Selma, Alabama)
Age: 55 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- We've had some services taken away in the past due to funding, which is always concerning.
- This funding means we might get more solid availability for healthcare.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 2 |
Nursing student (Syracuse, Kansas)
Age: 25 | Gender: female
Wellbeing Before Policy: 7
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- If our hospital stays open and fully funded, I can see a long-term career here.
- Closing or downsizing hospitals takes away jobs and healthcare options.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 6 |
| Year 2 | 8 | 6 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 7 | 4 |
| Year 20 | 7 | 3 |
Retired rancher (Lovelock, Nevada)
Age: 72 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 10/20
Statement of Opinion:
- Reliable healthcare through Medicare is a lifeline out here.
- The law could mean the difference between getting treated nearby versus driving hours away.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 4 | 2 |
Rural health advocate (Avery, Texas)
Age: 50 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 8/20
Statement of Opinion:
- Maintaining funding for hospitals means they can plan longer-term improvements.
- This bill could help prevent closures or limit their risks.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 7 | 4 |
| Year 5 | 7 | 4 |
| Year 10 | 6 | 3 |
| Year 20 | 5 | 3 |
Retired nurse (New Madrid, Missouri)
Age: 68 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 10.0 years
Commonness: 9/20
Statement of Opinion:
- It's difficult seeing our hospital struggle, knowing how critical it is for so many here.
- This aid can help keep things afloat.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 4 |
| Year 2 | 7 | 4 |
| Year 3 | 7 | 3 |
| Year 5 | 7 | 3 |
| Year 10 | 6 | 2 |
| Year 20 | 5 | 1 |
Cost Estimates
Year 1: $500000000 (Low: $450000000, High: $550000000)
Year 2: $505000000 (Low: $452500000, High: $557500000)
Year 3: $510000000 (Low: $455000000, High: $565000000)
Year 5: $520000000 (Low: $460000000, High: $580000000)
Year 10: $550000000 (Low: $480000000, High: $620000000)
Year 100: $1000000000 (Low: $850000000, High: $1150000000)
Key Considerations
- The permanence of these adjustments could signal increased Medicare spending as the population ages.
- Budget priorities will need to accommodate this ongoing expense, potentially from general funds or specific Medicare adjustments.
- Balancing rural healthcare access and federal budget is a critical policy consideration.