Heals Act
Floor Speech
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Mr. LANKFORD. Madam President, Senator Durbin and I have worked for months on an issue on rural healthcare. Whether it is in rural Illinois or it is in rural Oklahoma, there is a challenge dealing with rural hospitals and sustaining their viability.
So Senator Durbin and I partnered together to determine what is the best way to get a solution that is a long-term solution to what they are currently facing with COVID-19.
While COVID-19 has impacted all types of businesses, rural hospitals have uniquely dealt with some very difficult challenges. Getting PPE early on in the process was much more challenging for rural hospitals than it was for urban--keeping doctors, managing separation, getting airflow areas in hospitals to manage the flow of the virus through areas, and also managing just patient count, where, for many rural hospitals, they just shut down because all elective surgery was stopped and such, and so they lost all of that income, though they still had all the employees. It was an exceptionally challenging thing, but it is challenging on top of the challenge that they have already faced for decades in just surviving in rural America.
So what Senator Durbin and I have brought is a reasonable, nonpartisan solution to how we can deal with not only COVID-19 but to help rural hospitals long term.
Decades ago, Congress established something called the critical access hospital and made sure that those hospitals that were designated ``critical access hospitals'' would receive proper reimbursement from the Federal Government for healthcare services.
Many individuals in rural areas--in fact, the dominant proportion in many rural areas receiving healthcare are receiving it through Medicaid or Medicare. We want to make sure that those providers providing those high-need areas are reimbursed appropriately.
But, in 2006, Congress shifted the designation for critical access hospitals and took away something called the necessary provider, giving the flexibility to the States.
As a result of that action in 2006, we have seen the closure of 118 rural hospitals nationwide since that time period. The ``critical access hospital'' designation was created because of a string of hospital closures in the 1980s and early 1990s. Yet we have not responded in the way that we should from the change in statute in 2006.
Simply what we are trying to do is to give that flexibility back to States again. If they have a hospital in a rural area that is the only provider in that community that is a Medicare-dependent hospital or is a very small hospital with fewer than 50 beds, that area has to be an area that is designated as a rural area. It can't just be any suburban area or any other type of hospital. It has to be a rural hospital in particular. It has to have a high percentage relative to the national average of individuals with income below the poverty line. Those hospitals in those locations could be designated by their States as a necessary provider and be treated as if they are a critical access hospital. What would that do? That would be a lifeline for reimbursement because now we have some rural hospitals designated as critical access and some hospitals that meet all the other criteria, but they may be 34 miles away from another hospital, so that hospital in that county dies while the other hospital survives. In my State, we have a critical access hospital 34 miles away from a hospital across the border in Texas, so the hospital in Oklahoma can't get the critical access designation and can't survive because 34 miles away there is a hospital in another State that has the critical access.
We need the flexibility in our States to be able to do this kind of designation. Senator Durbin and I have run this through a lot of places and a lot of people, and we have gotten a lot of technical input in it to make sure this actually works for our rural hospitals and provides not just a short-term survival through COVID-19 but also provides long- term stability for them. This is the kind of work we should do together to make sure we stabilize those rural hospitals. They are a lifeline to people in rural America. They are a lifeline of employment, and they are a stable feature in every community. Without them, those communities dry up because people need access to healthcare, and this is the way that they can get it.
I am glad to partner with Senator Durbin on this issue, and it is our hope to get this into the next bill dealing with COVID-19 in the days ahead. Quite frankly, it was our hope to get it into the last one--we didn't get it--and into the one before that. Surprisingly enough, everyone seems to be nodding their heads on both sides of the aisle saying: That is a good idea. That will be effective. We want to move it from ``that is a good idea'' to ``done'' for the sake of rural hospitals across the Nation.
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