Each year the NRHA membership produces a Legislative and Regulatory Agenda that details the policy agenda of the association. As we prepare for 2009, we ask all members to take some time to read the 2008 Agenda and suggest any needed additions, changes or amendments. You can submit these through an online form. Submissions are due Nov. 15.

NRHA submitted questions on issues important to the rural health community to the candidates for President of the United States. This week, Sen. Obama sent NRHA his response. His responses are available by clicking on the full story link. Sen. Obama also sent a letter last week to attendees of the Rural Health Clinic and Critical Access Hospital conferences. If NRHA receives a response from Sen. McCain, his answers will be posted as well.

Both the House and Senate have passed legislation that will prevent group health plans from charging higher out-of-pocket costs and applying stricter treatment limits for mental health care than any other medical care. However, because the House and Senate used different legislative vehicles to pass the bill, final enactment of the bill is not assured. Congress must still take the final steps necessary to send the bill to the president for his signature. Fortunately, President Bush, business groups, insurance companies and mental health advocates all support the measure. The bill passed both houses overwhelmingly, and we expect that it will be enacted.

Thanks to the support of Congressional champions and our longstanding partners, the NRHA was able to secure the inclusion of language correcting a technical issue impacting most rural health clinics (RHCs) that could pass the Senate as soon as today and the House by early next week. The bill is the overall Health Care Safety Net Act (H.R. 1343) that includes Community Health Centers, the National Health Services Corps and Rural Health Outreach Grants. We still need your help to assure passage of these vital programs and that Congress and the Administration support additional RHC issues.

The NRHA applauds the passage of S. 901, the Health Care Safety Net Act which provides $12.9 billion dollars for rural and medically underserved areas. On July 22, the U.S. Senate unanimously passed S. 901; the House of Representatives earlier passed a similar bill. The act reauthorizes and strengthens three programs which together provide a safety net will help millions of rural Americans each year access needed health care services.

On July 23, Wayne Myers of the Maine Health Access Foundation testified on behalf of NRHA before the House Agriculture Subcommittee on Specialty Crops, Rural Development and Foreign Agriculture. The hearing was held to explore rural health disparities and found that critical telecommunication and work force challenges contribute to greater disparities in access to health care in rural areas. Subcommittee Chair Mike McIntyre (D-N.C.) said, "With limited dollars available for rural health care programs, we must ensure they are used in ways that address the challenges and with sufficient federal coordination." Dr. Myers discussed the importance of quality health care in rural America to both the community's citizens and the community's economy.

On the same day President Bush vetoed H.R. 6331, Congress overwhelmingly overrode that veto. The House of Representatives voted 383-41 and the Senate voted 70-26. Both the House and Senate had more votes to override the veto than were originally cast to send the bill to the president. The NRHA strongly supported passage of the bill, which provides nearly $2 billion critical dollars to rural America and eliminates the pending 10.6 percent cut in Medicare payments to physicians through December 2009.

Today, President Bush vetoed H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008. The legislation had previously passed both the Senate and the House with overwhelming support. H.R. 6331 would provide $2 billion in needed rural health care dollars and temporarily eliminate the 10.6 percent cut to Medicare reimbursement rates for physicians. Overriding the veto will require a two-thirds majority in both the House and Senate. The NRHA needs your immediate help to ensure that this bill will become law.

On June 26, the Senate failed to act on H.R. 6331, the Medicare Improvements for Patients and Providers Act of 2008, which would have halted the scheduled 10.6 percent payment cut and extended a number of vital rural provisions that approximately totaled $2 billion over 18 months.The vote to close debate failed by a single vote. The NRHA was disappointed by the Senate's inability to pass Medicare legislation before the July 1 deadline.

On June 24, 2008, the House of Representatives passed H.R. 6331, The Medicare Improvements for Patients and Providers Act of 2008, by a vote of 355 to 59. The NRHA endorsed this bill as it provides a number of improvements for rural seniors and providers.  Now the Senate must act.  Read on to find out how you can help rural health.

Providers paid under the Medicare physician fee schedule will receive 10.6 percent payment cuts on July 1st if Congress does not act. Both the House and Senate are working frantically to provide a package that will protect providers from this payment cut. On June 20th, NRHA staff met with House Democratic leadership on a proposed Medicare package. This comes as Senate Democrats and Republicans work on their own compromise package.

On June 18, after a long journey, the Senate voted 80 to 14 to override the President's veto of the Food Conservation, and Energy Act of 2008, the "Farm Bill." Earlier in the day, the House also voted to override the President's veto by a vote of 317 to 109. The Farm Bill is now officially law. 

On June 11, Senate Finance Committee Ranking Member Charles Grassley (R-IA) introduced the "Preserving Access to Medicare Act of 2008". The bill contains provisions to prevent rural providers from receiving the cuts in Medicare reimbursements scheduled for July 1. Several other provisions critical to rural America are also contained, but Congress must do more. 

On June 6, Senate Finance Committee Chairman Max Baucus (D-MT) introduced S. 3101, the “Medicare Improvements for Patients and Providers Act of 2008.”  In addition, on June 11, Senator Charles Grassley (R-IA) is introduced a similar bill, “Preserving Access to Medicare Act of 2008.” Both bills contain provisions to prevent rural providers from receiving the cuts in Medicare reimbursements scheduled for July 1.

May 2, 2008 - Senate and House negotiators announced today that they have reached a comprise on a new Farm Bill. Staff for the Senate and House agriculture committees and for conferees will continue to work on finalizing a few remaining issues and obtaining official budget scoring from the Congressional Budget Office, but the main issues have been agreed to. The completed legislation will have to be approved by both the Senate and House before being sent to the White House.

On April 23rd, the House of Representatives passed, by a veto proof majority of 349 to 62, legislation that prevent states from losing billions in federal dollars by placing a one-year moratorium on seven new Medicaid regulations. Earlier this week, the Bush Administration issued a formal veto threat against the legislation. The legislation moves to the Senate where its fate is less certain as it is not clear whether the votes are there to overturn a Presidential veto.

On March 13, Paul Moore testified on behalf of the NRHA before the House Appropriations Committee, Subcommittee on Labor, Health and Human Services, Education and related agencies on the rural health safety net, a group of programs that strengthen and build upon our rural health delivery system.