Our rural communities form the backbone of Tennessee, leading the nation in agriculture, manufacturing, forestry, and other vital industries. Many trace their roots to the nation’s founding era, with families passing down local history from one generation to the next. And it’s where the Volunteer Spirit comes alive, from churches and fire departments to 4-H chapters and Rotary clubs across our great state. 

But for far too long, these communities have faced barriers to a service essential to their long-term well-being: quality health care. Workforce shortages, long travel times, and underinvestment in facilities have all taken their toll. Since 2010, 18 rural hospitals in Tennessee have shut down or converted to models that exclude inpatient care, while 61 percent of those that remain open are vulnerable to closure—the highest rate in the country. Twenty-one counties have no hospital at all, forcing some residents to travel hours just to seek care.

These barriers not only worsen health outcomes; they also harm the broader well-being of these communities. When a 54-bed acute care facility in Jellico closed in 2021, 300 jobs were lost in a town of just 2,000 residents. Nearby restaurants and businesses were soon forced to close their doors. As one resident put it, “That hospital was not only the health care lifeline to this community. Economically and socially, it was the center of the community.”

Tennessee is far from alone. Nationwide, more than 400 rural health facilities are at risk of closing, and more than 40 percent operate at a loss. To address this crisis, I successfully fought to include the Rural Health Transformation Program in the Working Families Tax Cuts Act, which President Trump signed into law last year. Under the program, states are eligible for $50 billion in funding to strengthen access to health care in rural areas. In December, Tennessee received its first award through the program—nearly $207 million to increase workforce capacity, eliminate maternity-care deserts, expand access to telehealth services, and improve preventive care.

While these funds will go far in supporting rural health care, there is much more Congress can do to ensure that every Tennessean and American has access to quality care, regardless of zip code. As co-chair of the Senate Rural Health Caucus, I recently reintroduced my Rural Health Agenda, a bicameral and bipartisan package of three bills that would address the core challenges facing rural health care.

Too often, providers in rural communities struggle to attract talent from urban areas, which can offer higher compensation. My Rural America Health Corps Act would help address this imbalance by offering up to $200,000 in student loan repayments for clinicians who agree to work full-time for five years in rural areas facing workforce shortages.

Low patient volumes and financial pressures have also made it difficult for rural hospitals to remain open and invest in their services. My Rural Health Innovation Act would tackle these challenges by offering grants to Rural Health Clinics and Federally Qualified Health Centers to expand their ability to provide walk-in urgent care, triage, and emergency stabilization services.

Finally, the flawed Medicare Area Wage Index has unfairly forced rural hospitals to accept lower payment rates than high-wage urban markets. My Save Struggling Hospitals Act would correct this by ensuring that all hospitals receive fair Medicare reimbursement for the essential services they provide.

With Volunteer Spirit, our rural communities have always taken care of their own. Now, it’s time for Congress to ensure that these communities—and those across the country—have all the resources they need to thrive for generations to come.