Last week, the Pennsylvania House Insurance Committee, chaired by state Rep. Perry Warren, D-Bucks, reported out of committee four significant bills that safeguard health insurance in Pennsylvania in the event the federal government repeals protections of the Affordable Care Act. HB 404, 535, 618, and 755. The legislation seeks to ensure that consumers can maintain health insurance coverage to age 26, safeguarding health care protections by blocking coverage limits, prohibiting denial of health insurance coverage for pre-existing conditions, and maintaining access to preventative health care protections.

The National Rural Recruitment and Retention Network (3RNET) has released a new resource that rural health centers can use in their recruitment efforts. This guide is a basic overview of the benefits of working in a healthcare profession in a rural community and can be used to help with messaging to candidates or as a supplement to other materials your health center distributes. Check out this resource on 3RNET today.

The Centers for Disease Control and Prevention (CDC) released the new Urban-Rural Classification Scheme for Counties. Click here for information to rural definition eligibility for rural grants.

HHS issued a press release with initial information about the restructuring and downsizing of the Department. PACHC issued a statement. Key points for PCAs and CHCs include:

·    In total, HHS will reduce its staff by about 25%, from 82,000 to 62,000 FTE. About 10,000 employees have already separated from HHS since the start of the second Trump Administration, and another 10,000 will be receiving Reduction-in-Force (RIF) notices soon. No details are yet available about where these Reductions in Force (RIF) will occur.

·    HRSA will be absorbed into a new larger agency called the Administration for a Healthy America, or AHA. The other organizational entities being folded into AHA are:

o The Office of the Assistant Secretary for Health (OASH), which includes the Title X program, the Office of the Surgeon General, the Healthy People 2030 initiative, etc.

o The Substance Abuse and Mental Health Services Administration (SAMHSA), which is being downsized 50%.

o Agency for Toxic Substances and Disease Registry (ATSDR).

o The National Institute for Occupational Safety and Health (NIOSH), which is currently a research entity within the CDC. Note that NIOSH is different from OSHA.

There is no information on how this new agency will be structured, where it will be located, or who will lead it. However, HRSA is the largest agency being folded into AHA, and Health Centers are the largest program within HRSA, so it is expected that Health Centers will have a prominent role within the new AHA.

·    Regional offices are being downsized from 10 offices to 5 offices, but there is no definitive information yet on which ones are being eliminated. Based on a previous announcement from the HHS Office of the General Counsel, we expect that the Philadelphia, Atlanta, Kansas City, and Denver will remain, but it’s unclear where the fifth office will be.

Here are some additional points of interest:

·    A new office of the Assistant Secretary for Enforcement is being created, “to combat waste, fraud, and abuse in federal health programs.” It will include the HHS Office for Civil Rights (OCR) and oversee Departmental and Medicare hearings.

·    The CDC is not being broken up. Instead, the Administration for Strategic Preparedness and Response (ASPR), which leads HHS’ response efforts to national disaster and public health emergencies, will be transferred to the CDC.

In the press release, HHS Secretary Kennedy states that, “We aren’t just reducing bureaucratic sprawl…. This Department will do more – a lot more – at a lower cost to the taxpayer.” They estimate that the downsizing will save about $1.8 billion annually.

On March 6, National Governor’s Association (NGA) Chair Jared Polis (D-CO) and Vice Chair Kevin Stitt (R-OK) released a statement highlighting governors’ concerns over proposed Medicaid funding reductions in federal budget negotiations. The governors emphasized the need for state flexibility in administering Medicaid, SNAP, and TANF programs, warning that cuts without consultation could strain state budgets, impact rural hospitals, and disrupt healthcare providers. NGA urged Congress to ensure that governors have a voice in discussions on Medicaid policy changes and emphasized the importance of preserving state flexibility in delivering these programs. Read the full statement.

Recent legislation authorized an extension of many of the Medicare telehealth flexibilities. This includes:

·        Waiving geographic and originating site requirements through Sept. 30, 2025.

·        Allowing eligible practitioners to furnish telehealth services through Sept. 30, 2025.

·        Allowing Federally Qualified Health Centers and Rural Health Clinics to serve as distant site providers through Sept. 30, 2025.

·        Delaying in-person requirements for tele-mental health services through Sept. 30, 2025.

·        Allowing audio-only telehealth through Sept. 30, 2025.

Click here for Telehealth Policy Updates.

U.S. Senators Jerry Moran (R-KS), Tammy Baldwin (D-WI) and Shelley Moore Capito (R-WV) welcomed Sens. Tim Kaine (D-VA), Markwayne Mullin (R-OK) and John Hickenlooper (D-CO) as new members of the Senate 340B bipartisan working group. The Senate 340B working group was founded to advance bipartisan policy solutions that would make certain the program can continue to achieve its intended goal of supporting hospitals serving vulnerable populations like rural communities. Past work by the Senate 340B bipartisan working group:

·        In February 2024, the 340B working group released a legislative discussion draft and supplemental request for information which included solutions to improve the 340B program.

·        In 2023, the working group requested feedback from stakeholders on ways to improve the 340B program through bipartisan policy solutions.

Democrats swept the pair of special elections to fill vacancies in the state Senate and House. With the win in the House special election, Democrats will retain their razor-thin majority in that chamber with 102 Democrats and 101 Republicans. The results in that House race were hardly surprising; the district leans heavily towards the Democrats. In that race, Dan Goughnour got 63% of the vote to defeat the Republican nominee Charles D. Davis. In the Senate special election, the narrow win by James Malone means Democrats flipped the district, last held by former Sen. Ryan Aument, R-Lancaster. Despite that win, Republicans still hold the majority in the state Senate.

On Monday, the Federal Register published two final rules from the U.S. Department of Justice (DOJ) and Department of Health & Human Services (HHS) titled “Expansion of Buprenorphine Treatment via Telemedicine Encounter” and “Continuity of Care via Telemedicine for Veterans Affairs Patients.”  Originally scheduled to go into effect on March 21, 2025, the rules were delayed by a “Regulatory Freeze Pending Review.”  Following comments from the public received by the DOJ’s Drug Enforcement Agency, the effective date of both final rules is moved to December 31, 2025.

While not accepting any new applications for this Notice of Funding Opportunity that closed on January 27, HRSA is notifying existing applicants that the expected start date has been changed from May 1 to August 1, 2025.  We anticipate that successful applicants will be notified of grant funding in July 2025.  We plan to fund awards in 12-month budget periods for a total four-year period of performance from August 1, 2025 to July 31, 2029. Please note that the program and awards depend on the appropriation of funds and are subject to change based on the availability and amount of appropriations. HRSA plans to make approximately 50 awards to support rural communities to expand the delivery of health care services. Approximately 40 awards are for the program’s regular track to support rural community identified healthcare needs, and approximately 10 awards under the program’s special track to address to heart disease, cancer, unintentional injury/substance use, chronic lower respiratory disease, stroke, and maternal health