WASHINGTON — Federal lawmakers are urging Congress to help rural America in the next round of coronavirus legislation.
Congress approved more than $2 trillion in response to the pandemic in March, but many lawmakers say it doesn’t do enough to address the needs of rural Americans.
Media coverage of the pandemic has focused on urban hotspots like New York City, New Orleans and Seattle. But the virus is increasingly affecting rural places — and some fear the resources aren’t in place to address it.
Eighty-six percent of rural counties have had at least one case of COVID-19, according to Carrie Henning-Smith, a public health professor at the University of Minnesota. And cases and deaths are growing at faster rates in rural areas than in metropolitan ones, according to a report released last week by the Kaiser Family Foundation.
Rural Americans — who comprise 15 to 20% of the U.S. population — are at higher risk than their urban and suburban counterparts. They tend to be older, have higher rates of underlying health conditions and are more likely to have low incomes, live in poverty and be unemployed and uninsured, Henning-Smith said.
“When you look at the demographics of who’s living in rural America, they’re very susceptible to COVID-19,” said Maggie Elehwany, vice president of government affairs and policy at the National Rural Health Association.
The statistics are worse for minority groups in rural America, she said.
Rural Americans also have less access to healthcare providers, and many rural health facilities are struggling financially, she added.
The situation has been made worse by the COVID-19 pandemic, according to Dan Derksen, director of the University of Arizona Center for Rural Health. Individuals have been reluctant to access care because they fear exposure to the virus, and uncompensated or “charity” care has increased as people have lost their jobs — and the health insurance that goes along with it, he said. At the same time, hospitals and clinics have suspended elective surgeries, a main source of income.
The economic consequences of the pandemic are also of special concern in rural America, which hasn’t recovered from past recessions as quickly as other parts of the country, according to the Center for American Progress.
Congress has taken some steps that have aided rural America in relief packages so far, such as waiving restrictions on telehealth during the pandemic, supporting tribal communities and providing some support for increased access to high-speed internet.
The U.S. Department of Health and Human Services announced it would begin distributing $10 billion approved for rural hospitals.
But some lawmakers say more help is needed.
A priority item: federal aid for small towns and cities, which are facing major revenue losses in the wake of the pandemic. As a result, funding for police, fire departments, emergency responders, schools, trash collectors and libraries and other civic spaces is under threat.
The issue has become a flashpoint on Capitol Hill. Lawmakers from both parties have expressed support for aid to states and local governments, but some prominent Republicans — including Senate Majority Leader Mitch McConnell (R-Ky.) — have bristled at the idea.
In March, Congress set aside $150 billion in its $2.2 trillion coronavirus package to help cities and states respond to the pandemic. But the legislation only provides direct aid to municipalities with more than 500,000 people.
In April, U.S. Senators Bill Cassidy, M.D. (R-LA) and Bob Menendez (D-N.J.) unveiled a proposal to provide states and municipalities with $500 billion in stabilization funds, but counties and towns with less than 50,000 people wouldn’t be eligible for aid.
Such population thresholds highlight inequities facing small town America, Henning-Smith said.
U.S. Rep. Ron Kind (D-La Crosse) sent a letter to Treasury Secretary Steve Mnuchin urging him “ to take the necessary steps to ensure rural and small lenders have access to the emergency lending programs passed in the Coronavirus Aid, Relief, and Economic Security (CARES) Act.”
“I continue to hear from small businesses and lenders throughout my district in rural Wisconsin about having difficulties accessing SBA’s processing systems needed to administer programs like the Paycheck Protection Program (PPP),” Kind wrote.
He called for better oversight of the program, expressing disappointment that then-Acting Inspector General of Defense Glenn Fine was removed from his oversight role, and concern that “larger lending institutions will have first access to these programs, which are first come first served, leaving the smaller and rural lenders struggling to respond to the needs of their customers who desperately need access to these programs.”
“I look forward to working with you to best meet the needs of rural America during this difficult time,” Kind concluded.