Bill addresses rural health care access and physicians’ medical school debt

Twenty percent of Americans live in rural areas. Eleven percent of physicians practice in them. This certainly isn’t due to a lesser need for health care in rural America; it’s actually quite the opposite.

Compared to those in urban areas, rural Americans are at greater risk for death from heart disease, cancer and stroke. Patients seeking rural health care travel farther for primary, specialty and emergency care, and 53% lack the basic internet bandwidth needed for high-speed internet that could provide the option for telehealth.

Deaths from opioid overdose are 45% higher in rural America. Poverty, obesity and tobacco use are higher in rural America. However, access to health care is not.

Rural America Health Corps Act

As medical students, residents and physicians, we now have the opportunity to change this. Introduced to the Senate on March 23, 2021, the Rural America Health Corps Act seeks to increase the rural physician workforce and thus increase rural access to medical care.

The Rural America Health Corps Act was introduced by Sen. Marsha Blackburn (R-Tenn.) along with Sens. Dick Durbin (D-Ill.), Lisa Murkowski (R-Ala.), and Tina Smith (D-Minn.). As Sen. Blackburn has explained regarding the act, “Rural communities often find it challenging to recruit and retain health care practitioners. This legislation will create a Rural Health Corps to incentivize providers to practice and plant roots in rural communities.”

If passed, the Rural Health Corps Act would direct the Secretary of Health and Human Services to establish a program as part of the National Health Service Corps (NHSC) to provide payments on the principal of and interest on eligible education loans for eligible individuals.

While the NHSC does exist to provide physicians who serve two years in a health-shortage community with $50,000 in loan repayment, not all health-shortage communities are rural. Those communities that are rural still might not be able to retain a physician past those initial two years due to the physician’s need to seek a higher salary in a more urban location. The Rural Health Corps Act addresses this with a new incentive.

By serving the same two-year commitment, physicians will still be provided with $50,000 in loan repayment. But those who serve a longer five-year commitment in a rural community will receive up to $200,000 in loan repayment. In addition to creating these monetary incentives, the legislation also offers a sliding scale for repayment based on the severity of the rural healthcare shortage and waives any associated income tax liability.

Other bills that support rural health care access

In addition to supporting the Rural America Health Corps Act and the NHSC, the AOA has also fought for other policies created to address disparities in rural health care, including HR 5102: The Substance Use Disorder Workforce Loan Repayment Act of 2018, H.R. 6: The SUPPORT for Patients and Communities Act and H.R. 6576: The SURS Extension Act.

Introduced in February 2018, the Substance Use Disorder Workforce Loan Repayment Act of 2018 amends the Public Health Service Act to create a loan repayment program for individuals who complete a period of service in a substance use disorder treatment job in a mental health professional shortage area or a county where the drug overdose death rate is higher than the national average. Thanks to the efforts of medical students and physicians alike, this bill has passed the original chamber thus far.

H.R. 6: The SUPPORT for Patients and Communities Act was introduced in June 2018 and has since been enacted. It stands for Substance Use-Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities Act.

Most recent is H.R. 6576: The SURS Extension Act. Introduced in February 2022, the goal of this bill is to amend title XVIII of the Social Security Act to extend the Quality Payment Program-Small Practice, Underserved, and Rural Support program.

Taking action

In the last few years, osteopathic medical students and physicians have worked tirelessly to bring these bills to the floor. We have fought to improve rural access to health care in every way we can, and supporting the Rural America Health Corps Act is the next step.

You can send a letter to your legislators in support of the bill through the Osteopathic Advocacy Network, share the letter social media, and most timely of all, continue the momentum that we gained by advocating for the Rural America Health Corps Act during the 2022 DO Day at the end of April.

Related reading:

The Lorna Breen Act: Why mental health matters

CONNECTions for all: Expanding coverage for telemedicine beyond COVID