Jason Smith: Tackling the rural health care crisis

(From Eighth District Congressman Jason Smith)

For too long, Congress has allowed special interests and the politically connected to shape health care policies and legislation. As a result, we have a health care system that puts corporate interests – not patients – first. And no one has felt the consequences more than our rural communities, where the average life span is shorter compared to bigger towns and cities.

When I asked my colleagues for the privilege of running the Ways and Means Committee, I pledged that I would tackle the rural health care crisis affecting communities in every state in America. 

Earlier this month, I hosted listening sessions all across southern Missouri with a wide range of health care professionals and stakeholders to hear their proposals on how we can improve health care access in rural areas. The listening sessions were held just days after the Ways and Means Committee publicly requested input and ideas from our nation’s health care community, patients, and doctors on solutions that can help turn the tide against the very real disparities in access to care that exist for millions of Americans – particularly those in rural areas. It’s all part of my effort to give real Americans – not lobbyists or special interests – a direct seat at the table when it comes to crafting the policies we advance through the Ways and Means Committee.

Every American wants affordable health care, but it doesn’t matter how much care costs if you can’t get access to that care. Competition is crucial for any marketplace, and health care is no exception. At this point, more than half of all physicians are now employed by hospitals and large health systems – a trend that makes it difficult for independent physician practices to survive. During my listening session in Crystal City, a former primary care physician told me that a major factor discouraging physicians from practicing in rural areas is the lack of a work-life balance, whether it’s working incredibly long hours or spending far too much time dealing with burdensome Washington paperwork instead of treating patients. “It is exhausting work. I can tell you that firsthand. It is absolutely exhausting work,” the former primary care physician said.

At my listening session with nursing home administrators in Sikeston, one topic absolutely dominated the conversation: The harmful impact the Biden administration’s newly proposed staffing regulations will have on rural facilities. According to the administration’s own estimates, the proposal would cost nursing homes more than $40 billion over a decade, disproportionately hurting rural facilities that are already struggling to hire and retain qualified employees. As one nursing home administrator told me, “Staffing guidelines are not going to improve quality. All they’re going to do is create another platform for an inefficient use of federal money.” I couldn’t agree more.

In just the past 10 years, our congressional district has lost 5 rural hospitals. And when a hospital shuts down, it’s more than just access to care that goes away – employers are less likely to create jobs in those communities and investments in infrastructure and economic development are less likely to be targeted there as well. At my Fredericktown listening session, local hospital staff told me that a new Rural Emergency Hospital designation, a policy Congress created in 2021, for a St. Francois County hospital allows them to retain 24-hour emergency care services and provide much-needed primary care to rural patients. I am so grateful for Missouri State Senator Elaine Gannon and Missouri State Representative Mike Henderson for authoring the legislation at the state level that was needed to allow hospitals in our state to take advantage of the Rural Emergency Hospital designation. While I’m glad the policy is already making a real difference, the fight to protect rural hospitals is far from over.

Washington needs to hear the voices of Americans who are on the frontlines of the rural health crisis. The feedback I received from Missouri health care professionals and stakeholders was incredibly valuable, and will help craft the legislation we advance out of the Ways and Means Committee. Solving the rural health crisis won’t be easy. But make no mistake: I will continue fighting tooth and nail to advance the policies and legislation we need to fix our broken health care system and improve the quality of life in our rural communities.