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At a hearing before the House Small Business Subcommittees on Agriculture, Energy, and Trade and Health and Technology, Democrats took a hard look at the health care provider shortage plaguing rural America. While existing providers are often a robust source of local job and economic growth, physicians are increasingly flocking to urban areas. By deploying groundbreaking new technologies, telehealth allows doctors to collaborate and treat patients from nearly every corner of the globe. 

“Although it is still in its early stages, telehealth is expanding at a rapid rate and has the potential to dramatically improve access to quality care in a number of areas,” said Rep. Brad Schneider (D-IL), Ranking Member of the Subcommittee on Agriculture, Energy, and Trade. “Telehealth also has the potential to draw more doctors into practice in rural settings who would otherwise feel isolated and can be used to connect specialists with community providers, allowing practitioners to join a virtual community where they can receive mentoring and grow professionally.” 

Democrats highlighted the economic benefits that telehealth brings to local communities. Currently, the over 1500 rural hospitals nationwide support nearly 2 million jobs. For every dollar spent by a rural hospital, another $2.29 is yielded in economic activity. By keeping jobs within rural communities instead of forcing rural Americans to travel long distances to urban hubs for healthcare, Democrats stressed the potential of economic stability and growth. 

“Telehealth has the potential to advance health care quality while reducing costs,” said Rep. Al Lawson (D-FL), Ranking Member of the Subcommittee on Health and Technology. “It can save patients time and money in traveling to see their doctors, while also allowing small practices to broaden their scope. This also indirectly benefits the local small business economy by keeping dollars in the community and making rural areas more attractive.”

According to the American College of Physicians, around 82 percent of all doctor’s office visits occur in practices with five or fewer physicians. However, due to high costs and a changing demographic shift, the number of small medical practices is shrinking. As baby boomer providers are heading into retirement and younger physicians are shifting away from the practice setting, Dr. David Schmitz, President of the National Rural Health Association spoke to the importance of training and retaining quality rural health care providers. 

“Providers are more likely to practice in a rural setting if they have a rural background, participate in a rural training program and have a desire to serve rural community needs,” said Dr. Schmitz. 

The opioid crisis disproportionality affects rural Americans and up to 2.5 million individuals across the U.S. are currently suffering from opioid addiction. Meanwhile, 65% of rural counties do not have a practicing psychiatrist and 81 percent lack a psychiatric nurse practitioner. Telehealth technology such as video conferencing with a trained medical professional has shown to benefit those battling substance abuse and other mental illnesses. 

“Our constituents – and their families – need help. But they often have no place to go,” said Schneider. “Telehealth has the potential to bring high-quality behavioral health services to these suffering communities. Indeed, studies have shown that video telehealth users have satisfaction levels and outcomes similar to those of clients receiving in-person therapy.” 

With health reform on the Republican agenda, Democrats did not shy away from the positive impacts of the Affordable Care Act on rural America. A key provision of the ACA was the expansion of Medicaid. However, since the decision to expand the program which serves are the largest health insurance provider in the country was left up to the states. Many red states chose to forgo the expansion, which Democrats argued has only perpetuated poor health outcomes across rural areas. 

“Medicaid is a critical lifeline for rural and underserved communities,” said Schneider. “This is why efforts to repeal the progress the Affordable Care Act has made to provide coverage to underserved and rural communities are so misguided.” 

Telehealth remains a growing and vital component to increasing rural access to health care. However, Democrats stressed not only the importance of expanding telehealth but to addressing other factors such as a lack of funding for rural health care providers and a lack of affordable insurance for patients. 

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