IV 
114TH CONGRESS 
1ST SESSION 
H. RES. 398 
Recognizing that access to hospitals and other health care providers for 
patients in rural areas of the United States is essential to the survival 
and success of communities in the United States. 
IN THE HOUSE OF REPRESENTATIVES 
JULY 29, 2015 
Ms. JENKINS of Kansas (for herself and Mr. WELCH) submitted the following 
resolution; which was referred to the Committee on Energy and Commerce 
RESOLUTION 
Recognizing that access to hospitals and other health care 
providers for patients in rural areas of the United States 
is essential to the survival and success of communities 
in the United States. 
Whereas access to quality health care services determines 
whether individuals in the United States can remain in 
the communities they call home and whether their chil-
dren will return to those communities to raise families of 
their own; 
Whereas more than 60,000,000 individuals in rural areas of 
the United States rely on rural hospitals and other pro-
viders as critical access points to health care; 
Whereas rural areas of the United States need quality health 
care services to attract and retain business and industry; 
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•HRES 398 IH 
Whereas, to ensure that communities in the United States 
survive and flourish, Congress must address the unique 
health care needs of individuals in rural areas of the 
United States; 
Whereas individuals in rural areas of the United States are, 
per capita, older, poorer, and sicker than individuals in 
urban areas of the United States; 
Whereas, according to the Department of Health and Human 
Services, ‘‘rural areas have higher rates of poverty, 
chronic disease, and uninsurance, and millions of rural 
Americans have limited access to a primary care pro-
vider’’; 
Whereas, according to the Department of Agriculture, indi-
viduals in rural areas of the United States have higher 
rates of age-adjusted mortality, disability, and chronic 
disease than individuals in urban areas of the United 
States; 
Whereas the 19.3 percent of the population of the United 
States that lives in rural areas is scattered over 95 per-
cent of the landmass of the United States; 
Whereas the geography and weather of rural areas of the 
United States can make accessing health care difficult, 
and cultural, social, and language barriers compound 
rural health challenges; 
Whereas individuals in rural areas of the United States are 
more likely to be uninsured and more likely to receive 
coverage through public sources than individuals in urban 
areas of the United States; 
Whereas the proportion of uninsured and underinsured indi-
viduals is rising faster in rural areas of the United States 
than in urban areas of the United States; 
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•HRES 398 IH 
Whereas access to health care continues to be a major chal-
lenge in rural areas of the United States, as— 
(1) 97 percent of the 2,041 rural counties in the 
United States are designated as primary care Health 
Professional Shortage Areas (commonly referred to as 
‘‘HPSAs’’); 
(2) rural areas of the United States have 31-percent 
fewer primary care physicians per 100,000 people as 
urban areas of the United States; and 
(3) more than 40 percent of patients in rural areas 
of the United States travel at least 20 miles to receive 
specialty medical care, compared to only 3 percent of pa-
tients in urban areas of the United States; 
Whereas, because rural hospitals and other providers face 
unique challenges in administering care to patients, Con-
gress has traditionally supported those providers by im-
plementing— 
(1) specific programs to address rural hospital clo-
sures that occurred in the 1980s by providing financial 
support to hospitals that are geographically isolated and 
in which Medicare patients make up a significant per-
centage of hospital inpatient days or discharges; and 
(2) a program established in 1997 to support lim-
ited-service hospitals that, being located in rural areas of 
the United States that cannot support a full-service hos-
pital, are critical access points to health care for rural 
patients; 
Whereas hospitals in rural areas of the United States achieve 
high levels of performance, according to standards for 
quality, patient satisfaction, and operational efficiency, 
for the types of care most relevant to rural communities; 
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•HRES 398 IH 
Whereas, in addition to the vital care that rural health care 
providers provide to patients, rural health care providers 
are critical to the local economies of their communities 
and are one of the largest types of employers in rural 
areas of the United States where, on average, 10 to 15 
percent of total employment impact is attributed to the 
health sector; 
Whereas a hospital in a rural area of the United States is 
typically one of the top 2 largest employers in that area; 
Whereas 1 primary care physician in a rural community an-
nually generates approximately $1,400,000 in wages, sal-
aries, and benefits, and 1 general surgeon in a rural com-
munity annually generates approximately $1,400,000 in 
wages, salaries, and benefits and $2,700,000 in total rev-
enues; 
Whereas the average critical access hospital, a limited-service 
rural health care facility, creates 195 jobs and annually 
generates $8,400,000 in wages, salaries, and benefits, 
and the wages, salaries, and benefits provided by a crit-
ical access hospital can amount to 20 percent of the out-
put of a rural community’s economy; 
Whereas hospitals in rural communities play a vital role in 
caring for the residents of those communities and pre-
serving the special way of life that communities in the 
United States foster; and 
Whereas the closure of a hospital in a rural community often 
results in severe economic decline in the community and 
the departure of physicians, nurses, pharmacists, and 
other health providers from the community, and forces 
patients to travel long distances for care or to delay re-
ceiving care, leading to decreased health outcomes, higher 
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•HRES 398 IH 
costs, and added burden to patients: Now, therefore, be 
it 
Resolved, That the House of Representatives— 
(1) recognizes that access to hospitals and other 
health care providers for patients in rural areas of 
the United States is essential to the survival and 
success of communities in the United States; 
(2) recognizes that preserving and strength-
ening access to quality health care in rural areas of 
the United States is crucial to the success and pros-
perity of the United States; 
(3) recognizes that strengthening access to hos-
pitals and other health care providers for patients in 
rural areas of the United States makes Medicare 
more cost-effective and improves health outcomes for 
patients; 
(4) recognizes that, in addition to the vital care 
that rural health care providers provide to patients, 
rural health care providers are integral to the local 
economies and are one of the largest types of em-
ployers in rural areas of the United States; and 
(5) celebrates the many dedicated medical pro-
fessionals across the United States who work hard 
each day to deliver quality care to the nearly 1 in 
5 people in the United States living in rural areas, 
because the dedication and professionalism of those 
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•HRES 398 IH 
medical professionals preserves the special way of 
life and sense of community enjoyed and cherished 
by individuals in rural areas of the United States. 
Æ 
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