Bill Overview
Title: Rural Health Care Access Act of 2022
Description: 2022 This bill eliminates certain criteria that hospitals must meet in order to qualify as critical access hospitals that receive special payment under Medicare. Specifically, the bill eliminates the requirement that a hospital must either (1) be located more than 35 miles (15 miles in mountainous regions or areas with only secondary roads) from another hospital, or (2) have been certified prior to January 1, 2006, by the state as a necessary provider of services in the area.
Sponsors: Rep. Green, Mark E. [R-TN-7]
Target Audience
Population: People relying on rural hospitals for healthcare
Estimated Size: 57000000
- The bill impacts hospitals that are aiming to qualify as critical access hospitals. By modifying the qualification criteria, more hospitals may be eligible for special Medicare payments.
- Rural populations rely heavily on local hospitals for care, especially when larger facilities are far away.
- Increasing the number of critical access hospitals can expand healthcare access to remote and underserved populations by ensuring their local hospitals remain financially viable.
- According to USDA data from 2020, approximately 57 million Americans live in rural areas, which are the primary regions affected by changes to rural healthcare policy.
- There are globally many people living in rural areas, but since Medicare is a US-specific program, the changes primarily impact American rural populations.
Reasoning
- We aim to cover a diverse sample reflecting a range of impacts from the policy, acknowledging that some individuals will benefit more than others depending on their proximity and reliance on rural hospitals. Our sample includes rural residents directly impacted by the policy as well as others for whom the policy makes little difference.
- The policy's funding must sustain expanded Medicare reimbursements to newly qualifying critical access hospitals. Therefore, our interviews consider the varying degrees of hospital dependency across rural populations.
- By eliminating certain distance criteria, the policy could potentially be transformative for hospitals in emerging suburban-rural interfaces, creating nuanced shifts in access and service distribution among semi-rural populations.
Simulated Interviews
Farmer (Boone, Iowa)
Age: 45 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- I rely heavily on our local hospital for check-ups and monitoring my condition.
- If more hospitals qualify for Medicare support, it might mean better technology and more staff at my local facility.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 6 | 5 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 4 |
| Year 10 | 8 | 3 |
| Year 20 | 9 | 2 |
Retired (Grants Pass, Oregon)
Age: 62 | Gender: male
Wellbeing Before Policy: 4
Duration of Impact: 10.0 years
Commonness: 6/20
Statement of Opinion:
- My therapist says the hospital might get more funding, which could hire more staff.
- Less wait time would be fantastic, considering my travel time to get here.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 4 |
| Year 2 | 6 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 7 | 3 |
| Year 10 | 7 | 2 |
| Year 20 | 6 | 2 |
Teacher (Emporia, Kansas)
Age: 29 | Gender: female
Wellbeing Before Policy: 6
Duration of Impact: 15.0 years
Commonness: 5/20
Statement of Opinion:
- Access to pediatric services that are closer would be a relief.
- I'm optimistic this policy will help support local hospital services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 8 | 6 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 4 |
Construction Worker (Fargo, North Dakota)
Age: 53 | Gender: male
Wellbeing Before Policy: 5
Duration of Impact: 5.0 years
Commonness: 8/20
Statement of Opinion:
- More consistent access to urgent care would be beneficial for minor injuries.
- I hope the policy will ensure quick service for unexpected injuries.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 5 | 5 |
| Year 2 | 5 | 4 |
| Year 3 | 6 | 4 |
| Year 5 | 6 | 3 |
| Year 10 | 5 | 2 |
| Year 20 | 5 | 2 |
Nurse (Missoula, Montana)
Age: 39 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 3/20
Statement of Opinion:
- Better Medicare reimbursement could help us employ more staff.
- It might improve our hospital's capacity to handle emergency cases.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 9 | 5 |
| Year 20 | 9 | 4 |
Retired Military (Farmington, New Mexico)
Age: 70 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 7/20
Statement of Opinion:
- While I mostly use VA services, additional support for local hospitals can ease the burden on them.
- Better local facilities could benefit my non-military neighbors significantly.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 6 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 7 | 5 |
| Year 10 | 6 | 4 |
| Year 20 | 6 | 3 |
Freelance Writer (Jefferson City, Missouri)
Age: 34 | Gender: other
Wellbeing Before Policy: 7
Duration of Impact: 0.0 years
Commonness: 12/20
Statement of Opinion:
- Even with minimal physical hospital visits, improved healthcare services in the community can boost overall morale.
- An effective healthcare infrastructure supports mental well-being.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 7 | 7 |
| Year 2 | 7 | 7 |
| Year 3 | 7 | 7 |
| Year 5 | 7 | 7 |
| Year 10 | 7 | 7 |
| Year 20 | 7 | 7 |
Librarian (Woodstock, Vermont)
Age: 50 | Gender: female
Wellbeing Before Policy: 8
Duration of Impact: 15.0 years
Commonness: 9/20
Statement of Opinion:
- If local hospitals aren't under strain, it could make health initiatives easier.
- Happy local access to services will remain stable despite current hospital challenges.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 8 | 8 |
| Year 2 | 8 | 8 |
| Year 3 | 9 | 8 |
| Year 5 | 9 | 8 |
| Year 10 | 8 | 7 |
| Year 20 | 8 | 6 |
Veterinary Technician (Dothan, Alabama)
Age: 27 | Gender: male
Wellbeing Before Policy: 6
Duration of Impact: 10.0 years
Commonness: 5/20
Statement of Opinion:
- With a wedding coming up, knowing local healthcare is responsive is comforting.
- I hope the policy means better emergency response times.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 6 |
| Year 2 | 7 | 6 |
| Year 3 | 7 | 5 |
| Year 5 | 8 | 5 |
| Year 10 | 8 | 4 |
| Year 20 | 7 | 3 |
Ranch Owner (Green River, Wyoming)
Age: 48 | Gender: female
Wellbeing Before Policy: 5
Duration of Impact: 20.0 years
Commonness: 4/20
Statement of Opinion:
- The travel distance to major hospitals affects my business schedule.
- Hope this change supports more local services.
Wellbeing Over Time (With vs Without Policy)
| Year | With Policy | Without Policy |
|---|---|---|
| Year 1 | 6 | 5 |
| Year 2 | 7 | 5 |
| Year 3 | 8 | 4 |
| Year 5 | 8 | 4 |
| Year 10 | 9 | 3 |
| Year 20 | 9 | 2 |
Cost Estimates
Year 1: $4000000000 (Low: $3000000000, High: $5000000000)
Year 2: $4100000000 (Low: $3050000000, High: $5150000000)
Year 3: $4200000000 (Low: $3100000000, High: $5300000000)
Year 5: $4400000000 (Low: $3200000000, High: $5500000000)
Year 10: $5000000000 (Low: $4000000000, High: $6000000000)
Year 100: $10000000000 (Low: $8000000000, High: $12000000000)
Key Considerations
- Critical access hospitals receive higher Medicare reimbursements, impacting federal spending.
- The policy aims to increase healthcare access in rural areas, impacting approximately 57 million Americans according to USDA data.
- Increased health access can lead to better health outcomes and potentially improve local economies over time.