New! Policy Committee Issues Statement on Healthcare Reform Legislation

An essential part of the mission of the New England Rural Health RoundTable is to ensure that policy decisions at the state and federal level do not adversely affect health care provision in rural areas. The Policy Committee is charged with the responsibility for proposing activities designed to increase awareness of the needs of rural New England citizens and providers. The Committee reviews policies, procedures and legislation that impacts our rural areas and from time to time, issues policy statements.

The following is a Policy Statement sent to members of the congressional delegations of the New England states, as approved by the Board of Directors in October 2009.

“The New England Rural Health RoundTable would like to share our thoughts regarding the emerging healthcare reform legislation being crafted in Congress at this time. This summary is a follow-up to the meeting we held with members of the Congressional delegation of the New England states at the Capitol on June 15, 2009. The NERHRT is a non-profit 501(c)3 corporation, with a membership of over 700 organizations and individuals, committed to improving health and healthcare throughout the rural communities of Connecticut, Maine, Massachusetts, New Hampshire, Rhode Island and Vermont.

The NERHRT strongly supports the President’s goals as set forth in his recent speech to Congress. Rural areas have long struggled with higher rates of uninsurance and poverty, and have relied more heavily on subsidized public programs such as Medicaid and SCHIP. Efforts to expand coverage are vitally important to rural communities; however, without the proper safeguards regarding cost, choice, and provider access, we are concerned that the unique nature of our rural communities may undermine the effectiveness of the reform efforts.

Many of our concerns focus on the move away from a government run ‘Public Option’ that would be uniformly available nationwide. Reforms based on market competition alone will not function effectively in rural areas, where there are typically limited options in terms of both insurers and providers. Without a Public Option, NERHRT is concerned that reform efforts could force rural residents to purchase insurance from within the same limited, high cost options currently available in these areas. The decreased subsidy levels and other provisions proposed by the Senate Finance Committee would further exacerbate this situation.

As you struggle to find common ground on legislation to address our nation’s healthcare crisis, the NERHRT urges you to keep the unique nature of rural areas in mind. Specifically, please be sure that any final legislation does the following:

• Assure that residents of rural areas will have expanded insurance options available to the individual and small employer markets at reasonable cost.


• Assure that any providers participating in ‘Exchange’ programs, and/or any substitute for a Public Option (such as Co-Ops) be compelled to contract with, or otherwise cover the services of, the limited pool of providers in rural communities.


• Assure premium parity between insurance offerings in rural and urban areas over time and provide enforcement provisions.


• Assure that the federal premium subsidies are funded at a sufficient level to permit rural residents to participate without hardship and base subsidies on a portion of income, not a portion of premiums.


• Avoid provisions that would disproportionately impact rural areas, such as high ‘age rating’ rations that would impact the sub-Medicare elderly in rural areas, or disclosure provisions that could compel small rural employers to avoid hiring workers likely to access subsidized premium assistance.


• Recognize that insurance is just part of the problem with rural healthcare access, and assure that provisions to support and enhance the rural provide workforce are included in any final bill.

Thank you again for your representation of our region’s rural residents and the work you are doing to assure that meaningful action is taken to address this vital issue.