Weekly Columns

This isn’t just a big city problem. 

That was the message Dr. Nate Smith, Arkansas’s Secretary of Health, sought to impart when recently answering a reporter’s question about the alarming rise of recent positive COVID-19 diagnoses in rural Arkansas.

When the crisis began, our nation’s largest city was our hotspot. As the situation in New York City quieted down, the attention turned to other large cities struggling with coronavirus outbreaks. Whether it’s Miami, Houston or Los Angeles, the intense media focus on major metropolitan outbreaks fails to tell the whole story. The simple fact is, COVID-19 doesn’t care where you live, which makes the need to have top-notch medical care available in rural America all the more important.

Unfortunately, COVID-19 is putting us in danger of an even larger urban-rural divide in the ability to access quality health care services. Hundreds of rural hospitals across the country could close as a result of the crisis. This means tens of thousands of rural patients could lose access to their nearest emergency room. 

There was already a quiet storm brewing prior to the COVID-19 crisis. Nearly half of rural America’s hospitals had been operating at a loss and closure rates were escalating dramatically, hitting a record high last year. Closures in 2020 are on pace to eclipse that number.

These already financially-strapped hospitals now face catastrophic cash shortages as the inability to provide non-emergency care has led to an even larger loss of revenue. Many have furloughed staff, instituted massive cuts or are shuttering their doors. 

My colleagues and I are working to address this fragile situation and ensure that the health care needs of rural America are not lost in the rush to tamp down urban hotspots. I recently joined a bipartisan, bicameral effort with over 45 of my colleagues to ask the Department of Health and Human Services (HHS) to dedicate a larger share of the Provider Relief Fund specifically for rural health providers. 

Created by the Coronavirus Aid, Relief, and Economic Security (CARES) Act, the Provider Relief Fund was allocated $175 billion to distribute to hospitals and healthcare providers on the front lines of the coronavirus response. At the time of our inquiry, only $10 billion of that total amount has been disbursed specifically to rural health care providers.

We asked HHS Secretary Alex Azar to allocate at least 20 percent of the remaining funds to rural hospitals and providers. Priority should be granted to facilities significantly affected by COVID-19 preparation as well as those providing care for a disproportionally high percentage of Medicare and Medicaid patients or populations with above average senior populations or co-morbidities. Likewise, providers in areas with limited access to health infrastructure and high numbers of uninsured patients also deserve this particular consideration.

Earlier in the year, I joined another bipartisan effort asking Secretary Azar to use similar metrics to ensure equitable distribution of funds for rural hospitals from the Public Health and Social Services Emergency Fund.

The well-being of rural Arkansas residents will be at risk without action. So, too, is the future of their communities, as local health care systems are often the first thing that employers inquire about when deciding where to locate their companies. The rapidly increasing spread of COVID-19 in communities that are not large metropolitan areas makes the need to act all that more urgent. I will continue to push to ensure that the needs of Arkansas’s rural hospitals and providers are met.