BY ALLISON STEVENS, Correspondent | IOWA CAPITAL DISPATCH
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 America — and some fear the resources aren’t in place to address it.
“There still has to be a lot more done in order to help rural America,” said Rep. Ruben Gallego, D-Ariz.
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 health care 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 faced bans on 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.
Iowa Rep. Cindy Axne, D-3rd District, introduced a bill this week that would provide $700 million to support rural renters during the COVID-19 crisis. “Housing costs are not only an urban issue, but also we need to ensure that rural Americans don’t get forgotten or left out of relief efforts during these difficult times,” she said in a news release.
Iowa Rep. Abby Finkenauer, D-1st District, co-sponsored bipartisan legislation aimed at assisting rural community hospitals. “Too many hospitals in our rural communities face inadequate financial resources, threatening their ability to keep their doors open and provide care to Iowans,” Finkenauer said in a news release. “In the last decade alone, we’ve seen 128 rural hospitals shut down at the expense of rural patients, communities and economies. That’s simply unacceptable. They’re taking care of us, and we must take care of them — especially in the face of a pandemic.”
Another 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, a pair of bipartisan senators 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.