[Congressional Record Volume 163, Number 177 (Wednesday, November 1, 2017)]
[House]
[Page H8304]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1100
                    PROTECT RURAL AMERICA HOSPITALS

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Texas (Mr. Arrington) for 5 minutes.
  Mr. ARRINGTON. Mr. Speaker, if the United States is going to maintain 
the ability to feed and clothe our own people and fuel this American 
economy, we need a strong and sustainable rural America like the 
district I represent in west Texas.
  What would this country be without the hardworking energy and 
agriculture producers in small towns across this great land? The heart 
of small-town sustainability is access to healthcare. There are over 
5,000 hospitals in the United States, and roughly half of them are in 
rural America, serving one out of every five Americans. Without access 
to basic medical services, communities in America's breadbasket and 
energy basin would not survive.
  Hospitals serving rural communities face unique challenges: an aging 
population, low patient volume, higher percentages of Medicare 
beneficiaries, to name a few. Each translates into a higher per-patient 
cost which has left 41 percent of rural hospitals operating at a loss.
  On top of this problematic patient volume and patient mix, ObamaCare 
has heaped a backbreaking $54 billion in additional regulatory burden 
in unfunded mandates. Since 2010, the year ObamaCare was enacted, 80 
rural hospitals have shut down, 11 of which were in my home State of 
Texas. If this rate continues, in less than 10 years, an unimaginable 
25 percent of our Nation's rural hospitals will close. That would 
cripple rural communities across this country and deliver a devastating 
blow to our agriculture and energy economy, affecting all Americans, 
including our neighbors in urban and suburban America.
  For some Texans, the nearest hospital is already 100 miles away. In 
an emergency, this distance can mean the difference between life and 
death. Point of fact: 60 percent of all trauma deaths occur in rural 
America, despite the fact that rural America only makes up 20 percent 
of the country's population.
  Here is a startling fact and outright scary scenario: one-third of 
rural hospitals have been deemed vulnerable to closure. If all 673 of 
those hospitals were to close down, it could result in over 130,000 
jobs lost and almost $300 billion in GDP lost. When unemployment goes 
down and wages go down in those small towns, folks move away in search 
of better opportunities.
  In order to sustain the critical lifeline hospitals provide for our 
rural communities, I have introduced H.R. 4178, the Healthcare 
Enhancement for America's Rural Towns Act, or the HEART Act. Why? 
Because small towns are the heartbeat of America; the heart of our 
food, fuel, and fiber production; the heart of traditional American 
values. This legislation extends two programs vital to the 
sustainability of rural hospitals and the community they deserve: the 
Low-Volume Adjustment program and the Medicare-Dependent Hospital 
program. These programs account for less than one-tenth of 1 percent of 
all Medicare expenditures, but they go a long way to ensuring that 
rural community hospitals with a higher percentage of Medicare patients 
have adequate funding to serve the unique populations.
  By extending the Medicare Low-Volume Adjustment program for 2 years, 
and for the first time permanently extending the Medicare-Dependent 
Hospital program, we can provide the assurance and continuity that our 
rural hospitals desperately need in order to serve our communities in 
the future. Just as importantly, we do this in a way that is budget 
neutral and without spending any additional taxpayer moneys.
  Let's pass this legislation. Let's protect the heart of rural America 
and give our community hospitals the certainty that they need to keep 
our people and our communities healthy.

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