Capitol Correspondence - 03.04.19

Crisis in Rural Care Availability Inspires Recommendations from Former Senator Daschle, Including Expanding Telemedicine

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ANCOR is sharing this op-ed in the Des Moines Register by former Senate Majority Leader Tom Daschle, who served from 1987 to 2005 as a Democratic senator from South Dakota, as an additional perspective on the shortage of rural care which we covered last week. This might be of interest to ANCOR members, who have voiced concerns to ANCOR staff about the difficulties of finding care for people with disabilities in rural areas, which further compound the difficulties of finding physicians willing to treat people with disabilities on Medicaid.

As written by former Senator Daschle:

“[…] Voters voiced their strongly held view that every American should be eligible for care regardless of their medical condition. They also expressed deep concern over the rising costs of care and prescription drugs.


We can achieve this but we must do so with the recognition that, for the foreseeable future, neither an all-private nor all-public panacea is politically possible. But there is ample opportunity to make our PPP more effective.

First, encourage every state to expand Medicaid, benefiting millions of rural Americans.

Second, bolster the individual insurance market by raising the 400 percent of poverty cap on subsidy eligibility for those purchasing insurance in the marketplace.  It is also essential that the reinsurance program authorized in the ACA be given greater support.

Third, pass a 10-year reauthorization and expansion of community health centers (CHCs). CHCs are an invaluable source of quality, reliable care in rural America that can mean the difference between life and death to isolated Americans in urgent need of care.

Fourth, greatly expand telemedicine.  There is an enormous potential to provide care using virtual technology to millions of rural Americans.

Fifth, give health practitioners the latitude to provide care in the settings where they work. That includes nurses, nurse practitioners, physician assistants and pharmacists. Referred to as ‘expanded scope of practice,’ empowering providers in rural America with adequate authority to provide necessary care is essential.

Sixth, address the extraordinary deficiencies in the Indian Health Service (IHS). It is a tragedy that Native Americans living on reservations are relegated to care unfit in third- world countries. IHS budgets have been grossly underfunded and recruitment of high quality, professional providers has been a major failure. The time has come for our country to recognize its obligations and confront this crisis.

The crisis we face in health care in rural America poses a significant danger to the millions who live there. Whether a high quality of life can be sustained over the next decade depends upon the decisions Congress will make affecting public policy.”