Reconciliation Package Confronts Rural Health Challenges
Access to healthcare is a major challenge for patients and providers alike in rural communities across America, including in small cities and villages across Nebraska’s Third District. Families face long driving distances when they need care most, and a lack of patient density impedes the finances of providers striving to serve expansive areas. Doing all we can to promote economic growth, attract and support healthcare professionals to live and work in our state, and encourage healthy lifestyles are essential components of advancing solutions for Nebraskans.
In Congress, I have fostered support among my colleagues for legislation to modernize payments for health providers, reduce regulatory burdens, and update telehealth rules to strengthen Rural Health Clinics (RHCs) to better serve their communities. The Third District is served by over 50 Critical Access Hospitals (CAHs) and over 100 RHCs, among the most of any congressional district, and I have led legislation to successfully repeal regulatory burdens on these hospitals and modernize Medicare payments to ensure RHCs can continue providing frontline care.
Leveraging technology can open new ways for providers to reach and improve outcomes for rural patients. I am grateful the One Big Beautiful Bill Act, which I supported in the House and President Trump signed into law earlier this month, lowers barriers to telehealth services through a permanent provision based on my Telehealth Expansion Act. This ensures the millions of Americans with High-Deductible Health Plans can access affordable telehealth options before meeting their full deductible.
The reconciliation package provides an additional $50 billion to boost rural health providers and ends unworkable Biden-era nursing home staffing requirements which would have endangered the 90 percent of skilled-nursing facilities in Nebraska which already have a difficult time filling job openings.
Additionally, the One Big Beautiful Bill Act takes steps to address the sustainability of programs such as Medicaid by ensuring states prioritize and preserve coverage for mothers, children, disabled Americans, the elderly, the working poor, and others such programs have always been intended to help. Through policies proven successful during the 1990s, able-bodied adults are given modest requirements to work, participate in educational activities, or volunteer. Connecting more Americans to good-paying jobs is positive for the dignity of individuals and often the best path to financial security and family connection through economic support.
The bill also addresses abuse by states which have high rates of Medicaid payment errors. It requires states check the financial eligibility of their Medicaid recipients twice per year, instead of once. Nebraska has a comparatively low error rate for Medicaid payments, and states like California, with an 8.1 percent error rate, will be required to choose between addressing their waste, fraud, and abuse or seeing their federal match reduced, protecting taxpayers in responsible states like ours.
Many states take advantage of tools like State Directed Payments (SDPs) to a greater degree than Nebraska, which can disadvantage healthcare providers and taxpayers in our state. There needs to be fairness in a fiscally sustainable way, and I am glad officials worked hard to address it on the state level. In May, I joined Reps. Flood and Bacon to send a letter to Center for Medicaid and Medicare Services Administrator Mehmet Oz requesting Nebraska’s proposed SDP plan be approved in a timely manner, and the request was ultimately approved right before the deadline.
By advancing commonsense reforms which reduce barriers to telehealth and other emerging technologies and allowing programs such as Medicaid to help folks in need in the most efficient manner possible, I will continue working to make healthcare more accessible to patients across our state and the country.
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