Blackburn To Introduce Bipartisan Rural Health Agenda To Bring Care To Underserved Areas

March 15, 2023

WASHINGTON, D.C. – U.S. Senator Marsha Blackburn (R-Tenn.), co-chair of the Senate Rural Health Caucus, will introduce her Rural Health Agenda for the 118th Congress, aimed at addressing health care challenges in rural America to maintain quality care close to home. The Rural Health Agenda includes three separate bipartisan bills: the Rural Health Innovation Act, the Rural America Health Corps Act, and the Save Rural Hospitals Act. 

“My Rural Health Agenda will allow rural health care facilities to expand their hours of operation and hire additional medical providers. It will also incentivize more health professionals to work in rural health facilities in exchange for forgiving medical school loans. Lastly, rural hospitals must receive fair payment for the services they provide. As I meet annually with community leaders across all 95 counties in Tennessee, finding bipartisan solutions to improve access to rural healthcare is a priority,” said Senator Blackburn.

recent study found that “[m]ore than 600 rural hospitals – nearly 30% of all rural hospitals in the country – are at risk of closing in the near future. 50% of Tennessee’s rural hospitals are at risk of closing. 1 in 5 Tennesseans live in rural areas.


This bipartisan bill with Senator John Hickenlooper (D-Colo.) strengthens access to care in rural areas by incentivizing communities to leverage their existing resources to provide for the community’s urgent care needs. The bill would establish a competitive grant program allowing Federally Qualified Health Centers (FQHCs) (outpatient clinics that qualify for specific reimbursement under Medicare and Medicaid) or Rural Health Clinics (RHCs) (clinics located in rural underserved areas to boost access to primary care) to increase staffing resources, extend hours of operation, acquire additional technology and equipment, and pay for construction costs.

Specifically, the Rural Health Innovation Act:

  • Creates two 5-year grant programs, administered by the Health Resources and Services Administration’s Community-Based Division.
  • One grant program would help establish FQHCs and RHCs capable of meeting the community’s urgent care and triage needs; Grants will be limited to $500,000 for existing facilities and $750,000 for startup facilities.
  • The other grant program would expand rural health departments to meet urgent care and triage needs; Grants will be limited to $500,000. Communities must have an existing health department with a government-funded building, some nursing staff, and medical equipment.
  • Communities must be rural and be located at least thirty minutes from the nearest emergency department, using the speed limit on the most direct route from the proposed site to the nearest emergency department or be inaccessible by road.
  • Communities that have lost a hospital in the last seven years will have priority.

 Click here for bill text.


This bipartisan bill, co-led by Senator Dick Durbin (D-Ill.), incentivizes more health professionals to serve and plant roots in rural communities.

Specifically, the Rural America Health Corps Act:

  • Creates a new loan repayment program titled “NHSC Rural Provider Loan Repayment Program.”
  • Includes a range of providers such as nurse practitioners and physician assistants.
  • Ensures practitioners would be eligible for loan repayment on a sliding scale, based on the severity of the shortage in that area.
  • Waives any associated income tax liability for the loan repayment program.

 Click here for bill text.


This bipartisan bill, co-led by Mark Warner (D-Va.) and cosponsored by Senators Tim Kaine (D-Va.), John Cornyn (R-Texas), Raphael Warnock (D-Ga.), John Boozman (R-Wyo.), Cindy Hyde-Smith (R-Miss.), and Roger Wicker (R-Miss.), establishes an appropriate national minimum (.85) to the Medicare hospital area wage index. The bill would ensure that rural hospitals receive fair payment for the care they provide and to compete for and retain high-quality staff.

The Medicare Area Wage Index, a formula used to determine Medicare reimburse hospitals, is much lower for health care providers in rural communities, due to the fact that the formula is based on labor costs, which vary across the country. This flawed formula often results in disproportionately low Medicare reimbursement payments to hospitals in rural areas. 

Click here for bill text.