[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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