- House passes THUD appropriations bill, large gains in affordable housing and infrastructure
- President Trump forms White House Council on affordable housing, targets regulatory burden as primary barrier
- Center for Medicare and Medicaid Services proposes rule change to boost reimbursement for rural hospitals
- Report shows some economic gains in Appalachia, but distressed counties continue to slide
On the 25th of June, the full House passed a “minibus” bill package, which included several appropriation bills, including the Agriculture and Rural Development, and Transportation and Housing and Urban Development bills for Fiscal Year 2020. The House began its appropriation work on the assumption that a budget deal would be reached between Congress and the White House, and therefore the House’s proposed funding levels are higher than last year. Some of those highlights include $1.75 billion for the HOME Program (an increase of $500 million from FY19), almost $4 billion for Rural Development programs (an increase of $290 million from FY19), and NeighborWorks America’s requested allocation of $170 million (an $18 million increase from FY19 levels). The process now stalls as the bill moves to the Senate, which will not act until the budget deal negotiations are completed. Should those negotiations fail to reach an agreement on increased spending, many of the increases indicated above will not be in the final law.
President Trump has signed an executive order establishing a White House Council to boost affordable housing by decreasing the regulatory burden on developers. The Council is charged with targeting ideas at both the local and federal levels, including zoning reform, parking requirements, and changes to approval processes. While these regulatory changes have the potential to provide a boost in housing production, they lack the corresponding investments that would ensure that all Americans have a roof over their heads. Fahe encourages the Council to broaden its scope of inquiry, to ensure that it addresses the central issues that Fahe Members and Appalachian communities face.
A growing crisis for rural hospitals has led the Centers for Medicare & Medicaid Services (CMS) to propose changing the Medicare reimbursement rate. By reconfiguring the wage index, which adjusts reimbursements based upon local labor costs, the CMS is hoping to close a longstanding gap through which rural hospitals receive less compensation for the same services provided. The proposal would shift a small amount of funding from the top 75% of hospitals within the wage index system to the bottom 25%, moving existing funding around without increasing the cost of the program. Given the importance of healthcare to all communities, the well-documented crisis facing rural hospitals, and their higher reliance on Medicare reimbursements, this shift would provide a lifeline to healthcare systems in the lowest-income rural areas. However, this lifeline to help our rural neighbors whose medical centers are struggling will come at the cost of lower reimbursement rates at hospitals in higher cost-of-living areas. This issue is caught up in the overall challenges of rural economies and population loss, and the increasing cost of healthcare nationwide, and we hope and advocate for rural and urban residents to receive needed health care and all medical providers to be compensated fairly.
Coverage of a new report by the Appalachian Regional Commission (ARC) has found that many Appalachian communities with strong ties to the coal industry continue to struggle—despite a strong US national economy. While some counties have exhibited improvement, many continue to economically suffer following decades of disinvestment. The ARC points out that the 18 counties that experienced “negative shifts” in their economies primarily are coal-impacted counties. The report emphasizes the lack of good, available jobs in the region, an issue often overlooked because of the deceptively low national unemployment rate. When our communities are not doing well in the midst of our nation’s broader prosperity, it undermines us building the nation of robust opportunity and economic wellbeing we all want. Fahe encourages elected officials and those seeking to lead to examine the findings of this report, look at how many Americans are living in an economically precarious situation nationwide, and acknowledge that our national investments are not commensurate with the scale of the task at hand.