D.C. Dispatch: Legislators call for improved rural health care options

By: - October 7, 2022 4:27 pm

Iowa’s federal legislators are calling for more efforts to help rural health care facilities. (Photo by FS Productions/Getty Images)

As Congress prepares to recess until mid-November, Iowa’s federal legislators are calling for more efforts to help rural health care facilities.

U.S. Sen. Chuck Grassley and U.S. Rep. Mariannette Miller-Meeks said this week they are working to re-establish a Keokuk hospital under pending federal guidelines for Rural Emergency Hospital (REH) designations.

The Iowa Republicans sent a letter to Centers for Medicare and Medicaid Services Administrator Chiquita Brooks-LaSure asking for clarification as to whether Blessing Health Keokuk could be designated as an REH. The hospital announced in September that it would be effectively closing on Oct. 1, as hospital leaders said there was not enough demand for their medical services to financially support the operation.

The hospital is now going through the state’s Closure of an Institutional Health Facility process, and plans to maintain services including primary care and specialty clinics. Blessing Health Keokuk was open seven days a week with an emergency room and 49 beds for in-patient care.

Hospitals with 50 or fewer beds can seek permission to convert to REHs beginning Jan. 1, 2023, and participating facilities will then begin receiving Medicare payments for rural emergency services. The policy would allow rural hospitals to close in-patient beds that are not used often, while focusing on providing emergency and out-patient services.

The lawmakers asked Brooks-LaSure to clarify whether hospitals like Blessing Health Keokuk, which met the eligibility requirements for the program in 2020, would still be able to become REH facilities if they have closed before the new policy goes into effect.

“Access to emergency and primary health care services are basic quality of life issues for communities of any size,” Miller-Meeks and Grassley wrote in the letter. “We encourage CMS to ensure communities, including Keokuk, have the opportunity to establish a REH to maintain essential medical services and contribute to economic growth.”

While the Iowa legislators focused on the Keokuk facility, they said that this clarification could impact other rural facilities. Over 100 hospitals have closed in 28 states since 2013, according to data from the U.S. Government Accountability Office.

Local community leaders have called for the hospital’s reopening. Keokuk Mayor Kathie Mahoney said they are exploring “every option” to ensure quality health care is available in their region, with a focus on pursuing the REH classification.

“The loss to Keokuk and southeast Iowa is, at the very least, diminished health care for the region’s citizens and, at the extreme, the inability to save a life,” Mahoney said in a statement. “The city of Keokuk and community leaders are doing all they can to ensure we have access to high-quality health care services in the community.”

This week, Democratic U.S. Rep. Cindy Axne introduced legislation to support rural health care workers. The Supporting Our First Responders act, introduced with bipartisan co-sponsors, would authorize the U.S. Department of Health and Human Services to spend $50 million annually over the course of five years to create a grant program for EMS agencies. Grants could be used for improvements like training, hiring and the purchase of new equipment.

The legislation calls for 20% of the grant funds to go toward rural EMS agencies.

“Rural EMS teams go above and beyond to ensure that folks can get emergency care no matter where they live, and too often, they don’t have the resources necessary to do their jobs,” Axne said in a news release.

Republican representatives criticize Biden energy policies

The Russian invasion of Ukraine has already spurred energy concern in the U.S. as trade falters, but legislators responded this week to further concerns due to an announcement by OPEC+, a powerful oil producer group, that it is reducing production.

OPEC+, which includes Saudi Arabia and Russia, agreed Wednesday to cut oil production by 2 million barrels per day, a move energy analysts say is intended to spur an increase in crude oil prices. President Joe Biden’s administration criticized the “short-sighted” decision and called for the U.S. Department of Energy to deliver another 10 million barrels from the Strategic Petroleum Reserve. A White House statement from National Security Advisor Jake Sullivan and NEC Director Brian Deese said the administration is working with Congress to reduce U.S. dependence on OPEC+ and other foreign oil producers.

“Today’s announcement is a reminder of why it is so critical that the United States reduce its reliance on foreign sources of fossil fuels,” the officials said in a statement. “With the passage of the Inflation Reduction Act, the U.S. is now poised to make the most significant investment ever in accelerating the clean energy transition while increasing energy security.”

U.S. Rep. Ashley Hinson criticized Biden’s move and called for the administration to ramp up domestic energy production.

“President Biden’s strategy of begging other countries to produce oil has, unsurprisingly, failed,” Hinson said in a news release. “President Biden must stop draining our Strategic Petroleum Reserve and relying on other countries for energy production while ignoring domestic sources.”

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Robin Opsahl
Robin Opsahl

Robin Opsahl is an Iowa Capital Dispatch reporter covering the state Legislature and politics. Robin has experience covering government, elections and more at media organizations including Roll Call, the Sacramento Bee and the Wausau Daily Herald, in addition to working on multimedia projects, newsletters and visualizations. They were a political reporter for the Des Moines Register covering the Iowa caucuses leading up to the 2020 presidential election, assisting with the Register's Iowa Poll, and reporting on Iowa's 4th District elections.