[Congressional Record Volume 169, Number 151 (Tuesday, September 19, 2023)]
[House]
[Pages H4388-H4389]
From the Congressional Record Online through the Government Publishing Office [www.gpo.gov]




                              {time}  1030
                            RURAL HEALTHCARE

  The SPEAKER pro tempore. The Chair recognizes the gentleman from 
Pennsylvania (Mr. Thompson) for 5 minutes.
  Mr. THOMPSON of Pennsylvania. Mr. Speaker, before I was elected to 
serve in the House of Representatives, I spent nearly 30 years in the 
nonprofit healthcare field assisting those facing life-changing 
diseases and disabilities with therapists, rehabilitation service 
managers, and a licensed nursing home administrator.
  I am acutely aware of the challenges many face when it comes to 
obtaining reasonably priced healthcare. It is especially critical for 
rural America, like much of the 15th Congressional District of 
Pennsylvania that I am honored to serve.
  As the Member of Congress representing nearly one-third of the land 
mass of Pennsylvania, one of the most rural districts east of the 
Mississippi, I am keenly aware of the problems that my constituents 
face when accessing medical services.
  We are facing a healthcare crisis in our Nation's rural areas. These 
often disadvantaged populations are still struggling to access 
affordable, quality care. Many remain uninsured. Most are underinsured. 
However, access to quality care remains the largest challenge.
  Even when people gain access to health insurance, it doesn't mean 
equal access to care. Rural hospitals across the country are closing, 
leaving patients without access to emergency rooms and long-term care 
facilities.
  In addition to hospital closures, a workforce shortage plagues rural 
America. The patient-to-primary care

[[Page H4389]]

physician ratio in rural areas is only 39.8 physicians per 100,000 
people compared to 53.3 physicians per 100,000 in urban areas. 
Recruitment and retention of experienced professionals, including 
primary care physicians, is an ongoing challenge.
  Furthermore, the opioid epidemic that is sweeping the Nation has 
ravaged our rural communities, leaving even more of the population in 
need of crucial health services.
  Adolescents and young adults living in rural areas are more 
vulnerable to opioid abuse than their urban counterparts. The 
prevalence of fatal drug overdoses has skyrocketed in rural areas. High 
unemployment and a greater rate of types of injuries that result in 
prescriptions for opioid medications have contributed to this.
  On March 5, 2010, Congress passed sweeping legislation--the 
Affordable Care Act--which fundamentally realigned our Nation's 
healthcare system. Since passage of this bill, my worst nightmares have 
become a reality, as the law's interpretation continues to drive up 
costs, saddle small businesses with burdensome regulations, and impose 
unfunded mandates on people throughout the Commonwealth by shifting 
costs from the Federal Government to the States.
  Unfortunately, what we have also seen since the passage of this law 
is the consolidation of providers in the healthcare industry. Small and 
independent providers were unable to bear the burden of the ACA's 
various mandates, and many of them were forced to merge with larger 
health systems that have dramatically consolidated care over the last 
decade.
  Luckily, Congress has been able to repeal key components of this bill 
since it was first enacted, including the individual mandate. 
Additionally, as we emerge from the COVID-19 pandemic that uniquely 
strained rural healthcare systems in Pennsylvania and across the 
country, we must always look for ways to stabilize and recover from 
what has been a turbulent few years. Moving forward, we must provide 
commonsense reforms that improve our Nation's healthcare system and 
access across the country, including those in rural America.
  One of the best ways to do this is by promoting access to telehealth. 
As part of the National Telehealth Awareness Week, this week I plan to 
reintroduce the HEALTH Act, which allows community health centers and 
rural health clinics to continue to provide telehealth services and 
receive fair reimbursement for doing so. It is these types of policies 
that promote access to care for all Americans, and I look forward to 
working with my colleagues to fix our flawed healthcare system.
  Currently, healthcare costs have gone up, premiums have increased by 
double digits, but choices have decreased. That is not right. It is not 
fair, and it is not feasible. There must be a better way, and I know 
that together we will work to find a stable transition to a 21st 
century healthcare system that works for everyone in America, 
particularly those who live in rural regions where the need is great 
and services are scarce.

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