[Congressional Bills 115th Congress]
[From the U.S. Government Publishing Office]
[H. Res. 627 Introduced in House (IH)]
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115th CONGRESS
1st Session
H. RES. 627
Recognizing that access to hospitals and other health care providers
for patients in rural areas of the United States is essential to the
survival and success of communities in the United States.
_______________________________________________________________________
IN THE HOUSE OF REPRESENTATIVES
November 16, 2017
Ms. Jenkins of Kansas (for herself, Mr. Kind, Mrs. McMorris Rodgers,
and Mr. Welch) submitted the following resolution; which was referred
to the Committee on Energy and Commerce
_______________________________________________________________________
RESOLUTION
Recognizing that access to hospitals and other health care providers
for patients in rural areas of the United States is essential to the
survival and success of communities in the United States.
Whereas access to quality health care services determines whether individuals in
the United States can remain in the communities they call home and
whether their children will return to those communities to raise
families of their own;
Whereas more than 60,000,000 individuals in rural areas of the United States
rely on rural hospitals and other providers as critical access points to
health care;
Whereas rural areas of the United States need quality health care services to
attract and retain business and industry;
Whereas to ensure that communities in the United States survive and flourish,
Congress must address the unique health care needs of individuals in
rural areas of the United States;
Whereas individuals in rural areas of the United States are, per capita, older,
poorer, and sicker than individuals in urban areas of the United States;
Whereas the population in rural areas is composed of 10.4 percent of veterans in
need of care, compared to only 7.8 percent in urban areas;
Whereas the rate of disability for individuals increases from 11.8 percent in
urban areas to 17.7 percent in rural counties;
Whereas pregnant women are being left without care as 54 percent of rural
counties do not have hospital-based obstetrics due to high costs and
staffing shortages;
Whereas according to the Department of Health and Human Services, ``rural areas
have higher rates of poverty, chronic disease, and uninsurance, and
millions of rural Americans have limited access to a primary care
provider'';
Whereas according to the Department of Agriculture, individuals in rural areas
of the United States have higher rates of age-adjusted mortality,
disability, and chronic disease than individuals in urban areas of the
United States;
Whereas the 20 percent of the population of the United States that lives in
rural areas is scattered over 97 percent of the landmass of the United
States;
Whereas the geography and weather of rural areas of the United States can make
accessing health care difficult, and cultural, social, and language
barriers compound rural health challenges;
Whereas individuals in rural areas of the United States are more likely to be
uninsured and more likely to receive coverage through public sources
than individuals in urban areas of the United States;
Whereas the proportion of uninsured and underinsured individuals is rising
faster in rural areas of the United States than in urban areas of the
United States;
Whereas the growing opioid epidemic has placed an even greater burden on the
limited care resources in rural communities as--
(1) it is estimated that as many as 2.5 million people in the United
States are suffering from opioid addiction related to prescriptions, and an
additional 467,000 are addicted to heroin;
(2) eighty percent of people addicted to opioids do not receive
treatment, and those who do are severely limited by the types of treatment
available especially in rural areas;
(3) according to the Centers for Disease Control and Prevention (CDC),
the counties that prescribe the most opioids are likely to be in rural
areas, where the unemployment rate stands nearly two percentage points
higher than the national average; and
(4) according to the CDC, the rate of death from opioid-related
overdoses is 45-percent higher in nonmetropolitan counties;
Whereas access to health care continues to be a major challenge in rural areas
of the United States, as--
(1) less than 11 percent of physicians in the United States practice in
rural areas;
(2) nearly 60 percent of areas designated as primary care Health
Professional Shortage Areas (commonly referred to as ``HPSAs'') are rural
and more than 3,000 physicians would be needed to remove these
designations;
(3) rural areas of the United States have fewer than half as many
primary care physicians per 100,000 people as urban areas of the United
States; and
(4) more than 50 percent of patients in rural areas of the United
States travel at least 20 miles to receive specialty medical care, compared
to only 6 percent of patients in urban areas of the United States;
Whereas rural hospitals and other providers are facing a growing closure crisis
as--
(1) 82 rural hospitals have closed since 2010 and 673 rural hospitals
are in severe financial crisis, representing one-third of the rural
hospitals in the United States;
(2) because of the closure of these 82 rural hospitals, 99,000 health
care jobs have been lost and 137,000 community jobs have been lost;
(3) at this rate, 25 percent of rural hospitals will have shut down in
the next ten years; and
(4) medical deserts are being created across rural America, leaving
many of our Nation's most vulnerable populations without timely access to
care;
Whereas because rural hospitals and other providers face unique challenges in
administering care to patients, Congress has traditionally supported
those providers by implementing--
(1) specific programs to address rural hospital closures that occurred
in the 1980s by providing financial support to hospitals that are
geographically isolated and in which Medicare patients make up a
significant percentage of hospital inpatient days or discharges; and
(2) a program established in 1997 to support limited-service hospitals
that, being located in rural areas of the United States that cannot support
a full-service hospital, are critical access points to health care for
rural patients;
Whereas hospitals in rural areas of the United States achieve high levels of
performance, according to standards for quality, patient satisfaction,
and operational efficiency, for the types of care most relevant to rural
communities;
Whereas in addition to the vital care that rural health care providers provide
to patients, rural health care providers are critical to the local
economies of their communities and are one of the largest types of
employers in rural areas of the United States where, on average, 14
percent of total employment is attributed to the health sector;
Whereas a hospital in a rural area of the United States is typically one of the
top 2 largest employers in that area;
Whereas 1 primary care physician in a rural community annually generates
approximately $1,500,000 in total revenue, and 1 general surgeon in a
rural community annually generates approximately $2,700,000 in total
revenue;
Whereas the average Critical Access Hospital, a limited-service rural health
care facility, creates 107 jobs and generates $8,400,000 in annual
payroll, and the wages, salaries, and benefits provided by a Critical
Access Hospital can amount to 20 percent of the output of a rural
community's economy;
Whereas hospitals in rural communities play a vital role in caring for the
residents of those communities and preserving the special way of life
that communities in the United States foster; and
Whereas the closure of a hospital in a rural community often results in severe
economic decline in the community and the departure of physicians,
nurses, pharmacists, and other health providers from the community, and
forces patients to travel long distances for care or to delay receiving
care, leading to decreased health outcomes, higher costs, and added
burden to patients: Now, therefore, be it
Resolved, That the House of Representatives--
(1) recognizes that access to hospitals and other health
care providers for patients in rural areas of the United States
is essential to the survival and success of communities in the
United States;
(2) recognizes that preserving and strengthening access to
quality health care in rural areas of the United States is
crucial to the success and prosperity of the United States;
(3) recognizes that strengthening access to hospitals and
other health care providers for patients in rural areas of the
United States makes Medicare more cost effective and improves
health outcomes for patients;
(4) recognizes that, in addition to the vital care that
rural health care providers provide to patients, rural health
care providers are integral to the local economies and are one
of the largest types of employers in rural areas of the United
States; and
(5) celebrates the many dedicated medical professionals
across the United States who work hard each day to deliver
quality care to the nearly 1 in 5 people in the United States
living in rural areas, because the dedication and
professionalism of those medical professionals preserves the
special way of life and sense of community enjoyed and
cherished by individuals in rural areas of the United States.
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