HEART Act

Mr. Speaker, if the United States is going to maintain the ability to feed and clothe our own people and fuel this American economy, we need a strong and sustainable rural America like the district I represent in west Texas.

What would this country be without the hardworking energy and agriculture producers in small towns across this great land? The heart of small-town sustainability is access to healthcare. There are over 5,000 hospitals in the United States, and roughly half of them are in rural America, serving one out of every five Americans. Without access to basic medical services, communities in America's breadbasket and energy basin would not survive.

Hospitals serving rural communities face unique challenges: an aging population, low patient volume, higher percentages of Medicare beneficiaries, to name a few. Each translates into a higher per-patient cost which has left 41 percent of rural hospitals operating at a loss.

On top of this problematic patient volume and patient mix, ObamaCare has heaped a backbreaking $54 billion in additional regulatory burden in unfunded mandates. Since 2010, the year ObamaCare was enacted, 80 rural hospitals have shut down, 11 of which were in my home State of Texas. If this rate continues, in less than 10 years, an unimaginable 25 percent of our Nation's rural hospitals will close. That would cripple rural communities across this country and deliver a devastating blow to our agriculture and energy economy, affecting all Americans, including our neighbors in urban and suburban America.

For some Texans, the nearest hospital is already 100 miles away. In an emergency, this distance can mean the difference between life and death. Point of fact: 60 percent of all trauma deaths occur in rural America, despite the fact that rural America only makes up 20 percent of the country's population.

Here is a startling fact and outright scary scenario: one-third of rural hospitals have been deemed vulnerable to closure. If all 673 of those hospitals were to close down, it could result in over 130,000 jobs lost and almost $300 billion in GDP lost. When unemployment goes down and wages go down in those small towns, folks move away in search of better opportunities.

In order to sustain the critical lifeline hospitals provide for our rural communities, I have introduced H.R. 4178, the Healthcare Enhancement for America's Rural Towns Act, or the HEART Act. Why? Because small towns are the heartbeat of America; the heart of our food, fuel, and fiber production; the heart of traditional American values. This legislation extends two programs vital to the sustainability of rural hospitals and the community they deserve: the Low-Volume Adjustment program and the Medicare-Dependent Hospital program. These programs account for less than one-tenth of 1 percent of all Medicare expenditures, but they go a long way to ensuring that rural community hospitals with a higher percentage of Medicare patients have adequate funding to serve the unique populations.

By extending the Medicare Low-Volume Adjustment program for 2 years, and for the first time permanently extending the Medicare-Dependent Hospital program, we can provide the assurance and continuity that our rural hospitals desperately need in order to serve our communities in the future. Just as importantly, we do this in a way that is budget neutral and without spending any additional taxpayer moneys.

Let's pass this legislation. Let's protect the heart of rural America and give our community hospitals the certainty that they need to keep our people and our communities healthy.