Improving Care in Rural America Reauthorization Act of 2025

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Bill ID: 119/s/2301
Last Updated: January 4, 2026

Sponsored by

Sen. Scott, Tim [R-SC]

ID: S001184

Follow the money

The bill

Improving Care in Rural America Reauthorization Act of 2025

S. 2301, 119th Congress — read as touching Hospitals & Health Systems.

The sponsor

Sen. Scott, Tim [R-SC]

Every bill has someone who introduced it. That name is where the paper trail starts.

The money

$287,300 raised

26 itemised contributions to this sponsor, pulled from FEC filings.

The alignment

95% match to Project 2025

This bill's text tracks the "Department of Health and Human Services" section, p. 530-532 of the Mandate for Leadership.

Bill's Journey to Becoming a Law

Track this bill's progress through the legislative process

Latest Action

Placed on Senate Legislative Calendar under General Orders. Calendar No. 153.

September 7, 2025

Introduced

📍 Current Status

Next: The bill will be reviewed by relevant committees who will debate, amend, and vote on it.

🏛️

Committee Review

🗳️

Floor Action

✅

Passed Senate

🏛️

House Review

🎉

Passed Congress

🖊️

Presidential Action

⚖️

Became Law

📚 How does a bill become a law?

1. Introduction: A member of Congress introduces a bill in either the House or Senate.

2. Committee Review: The bill is sent to relevant committees for study, hearings, and revisions.

3. Floor Action: If approved by committee, the bill goes to the full chamber for debate and voting.

4. Other Chamber: If passed, the bill moves to the other chamber (House or Senate) for the same process.

5. Conference: If both chambers pass different versions, a conference committee reconciles the differences.

6. Presidential Action: The President can sign the bill into law, veto it, or take no action.

7. Became Law: If signed (or if Congress overrides a veto), the bill becomes law!

Bill Summary

Another masterclass in legislative theater, courtesy of the 119th Congress. Let's dissect this farce, shall we?

**Main Purpose & Objectives:** The Improving Care in Rural America Reauthorization Act of 2025 is a rehashing of existing programs with a fancy new title. Its primary objective is to make politicians look like they care about rural healthcare while actually doing very little.

**Key Provisions & Changes to Existing Law:**

* Section 2(a) and (b) add more bureaucratic language to ensure that grant funds are used for "rural underserved populations." Wow, what a bold move. It's not like this is just a rewording of existing requirements. * The real meat of the bill is in Section 2(c), which reauthorizes funding for these programs from 2026 to 2030. Because, you know, throwing more money at a problem always solves it.

**Affected Parties & Stakeholders:**

* Rural healthcare providers will get some extra cash, but only if they jump through the right hoops and fill out enough paperwork. * Patients in rural areas might see some minor improvements, but don't hold your breath. This bill is more about optics than actual change. * Lobbyists for rural healthcare organizations are probably thrilled to have something to do.

**Potential Impact & Implications:**

* The impact will be negligible, as this bill doesn't address the systemic issues plaguing rural healthcare, such as lack of funding, inadequate infrastructure, and brain drain. * The real implication is that politicians get to pretend they're doing something about rural healthcare while actually just kicking the can down the road.

Diagnosis: This bill suffers from a severe case of "Legislative Lip Service Syndrome" (LLSS), characterized by empty promises, bureaucratic jargon, and a complete lack of meaningful action. The symptoms are clear: politicians want to look good without doing any actual work.

Treatment: A healthy dose of skepticism, followed by a strong prescription of reality-based policy-making. But don't worry, this bill will likely pass with flying colors, because who needs actual progress when you can just reauthorize existing programs and call it a day?

Related Topics

Healthcare & Insurance Reform
Generated using Llama 3.1 70B (Dr. Haus personality)

💰 Campaign Finance Network

Sen. Scott, Tim [R-SC]

Congress 119 • 2024 Election Cycle

Total Contributions
$287,300
24 donors
PACs
$0
Organizations
$23,300
Committees
$0
Individuals
$264,000

No PAC contributions found

1
FAIRWAY INVESTMENTS, LLC
2 transactions
$16,500
2
MK INTERNATIONAL LLC
1 transaction
$3,300
3
OSWALD COOKE & ASSOCIATES, LLC
1 transaction
$1,500
4
HUDSON CAPITAL ADVISORS LLC
1 transaction
$1,000
5
MORONGO BAND OF MISSION INDIANS
1 transaction
$1,000

No committee contributions found

1
EMMET, RICHARD
2 transactions
$26,400
2
BOLDRICK, JAMES
1 transaction
$13,200
3
DUHAMEL, WILLIAM
1 transaction
$13,200
4
GROFF, SUSAN
1 transaction
$13,200
5
SLUSKY, ALEX
1 transaction
$13,200
6
HAMMOND, GREGORY
1 transaction
$13,200
7
NAVARRO, ANNE
1 transaction
$13,200
8
NEWMAN, BRAD
1 transaction
$13,200
9
ANDERSON, MORGAN
1 transaction
$13,200
10
BROWN, JAMES
1 transaction
$13,200
11
CANN, DAVID
1 transaction
$13,200
12
CHAMBERLAIN, LEE
1 transaction
$13,200
13
COLQUITT, DAVID
1 transaction
$13,200
14
CONVERSE, JUSTIN
1 transaction
$13,200
15
DEERING, TONY
1 transaction
$13,200
16
DEJONG, ROBERT
1 transaction
$13,200
17
GOLDBAUM, ROBERT
1 transaction
$13,200
18
HASLAM, BILL
1 transaction
$13,200
19
HASLAM, JAMES
1 transaction
$13,200

Cosponsors & Their Campaign Finance

This bill has 3 cosponsors. Below are their top campaign contributors.

Sen. Smith, Tina [D-MN]

ID: S001203

Top Contributors

10

1
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Jan 23, 2024
2
OTOE MISSOURIA TRIBE OF OKLAHOMA
OrganizationRED ROCK, OK
$3,300
Jan 23, 2024
3
MUSCOGEE CREEK NATION
OrganizationOKMULGEE, OK
$2,000
Dec 28, 2023
4
MIAMI TRIBE OF OKLAHOMA
OrganizationMIAMI, OK
$2,000
Mar 18, 2024
5
MUSCOGEE CREEK NATION
OrganizationOKMULGEE, OK
$2,000
Jul 31, 2024
6
MILLE LACS BAND OF OJIBWE INDIANS
OrganizationONAMIA, MN
$1,300
Jun 27, 2023
7
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,300
Jun 27, 2023
8
MUSCOGEE CREEK NATION
OrganizationOKMULGEE, OK
$1,300
Jul 31, 2024
9
MILLE LACS BAND OF OJIBWE INDIANS
OrganizationONAMIA, MN
$1,200
Jun 27, 2023
10
FOND DU LAC BAND
OrganizationCLOQUET, MN
$1,000
Jun 27, 2023

Sen. Lummis, Cynthia M. [R-WY]

ID: L000571

Top Contributors

10

1
HEGYI, ALBERT P
1ST FINANCIAL BANK USA • BANKER
IndividualNEW YORK, NY
$6,600
Dec 6, 2023
2
MANDELBLATT, DANIELLE
RETIRED • RETIRED
IndividualASPEN, CO
$6,600
Sep 26, 2024
3
MANDELBLATT, ERIC
SOROBAN CAPITAL PARTNERS LP • MANAGING PARTNER
IndividualASPEN, CO
$6,600
Sep 26, 2024
4
SAMANI, PYAHM
IndividualAUSTIN, TX
$5,800
Aug 8, 2023
5
CASCARILLA, MARISSA
NA • HOMEMAKER
IndividualMIAMI, FL
$3,700
Apr 1, 2024
6
CASCARILLA, CHARLES
PAXOS • CEO
IndividualMIAMI, FL
$3,700
Apr 1, 2024
7
DOWNS, RAISSA
TARPLIN, DOWNS AND YOUNG, LLC • CONSULTANT
IndividualWASHINGTON, DC
$3,600
Dec 12, 2024
8
SCARAMUCCI, ANTHONY
SKYBRIDGE • MANAGING PARTNER
IndividualPLANDOME, NY
$3,435
Jul 30, 2024
9
HOBART, ROBERT
VENTURE GOVERNMENT STRATEGIES • CONSULTANT
IndividualNASHVILLE, TN
$3,435
Aug 5, 2024
10
HOLDING, KATHLEEN MS.
SUNLIGHT RANCH CO. • EXECUTIVE
IndividualDAYTON, WY
$3,300
Dec 6, 2023

Sen. Kaine, Tim [D-VA]

ID: K000384

Top Contributors

10

1
THE CHICKASAW NATION
OrganizationADA, OK
$2,300
Jun 18, 2024
2
THE CHICKASAW NATION
OrganizationADA, OK
$1,000
Jun 26, 2023
3
SAN MANUEL BAND OF MISSION INDIANS
OrganizationLOS ANGELES, CA
$1,000
Jun 18, 2024
4
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$1,000
Jun 25, 2024
5
THE CHICKASAW NATION
OrganizationADA, OK
$1,000
Jun 18, 2024
6
CHOCTAW NATION OF OKLAHOMA
OrganizationDURANT, OK
$1,000
Oct 15, 2024
7
CHEROKEE NATION
OrganizationTAHLEQUAH, OK
$1,000
Dec 29, 2023
8
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$600
Oct 25, 2023
9
STONEHALL FARM
OrganizationTHE PLAINS, VA
$500
Jun 30, 2024
10
SHAKOPEE MDEWAKANTON SIOUX COMMUNITY
OrganizationPRIOR LAKE, MN
$400
Oct 25, 2023

Donor Network - Sen. Scott, Tim [R-SC]

PACs
Organizations
Individuals
Politicians

Hub layout: Politicians in center, donors arranged by type in rings around them.

Loading...

Showing 53 nodes and 35 connections (55 secondary connections hidden)

Total contributions: $320,000

Top Donors - Sen. Scott, Tim [R-SC]

Showing top 24 donors by contribution amount

5 Orgs19 Individuals

Industry Impact

Which industries are materially affected by specific provisions in this bill. 2 helped.

  • Section 2(a)-(c) reauthorizes and amends grant programs for rural health care services outreach, rural health network development, and small health care provider quality improvement, which would benefit hospitals and health systems operating in rural areas by providing funding for services and network development.

  • The grant programs could support long-term care providers in rural areas as part of integrated health care networks, though the text does not explicitly mention long-term care.

Who funds the sponsor on these industries

For each industry this bill affects, here's what the sponsor (Sen. Scott, Tim [R-SC])received from donors associated with that industry during the 2022–present cycles. Donations are not proof of intent — they are a record of who funds the people writing the law.

Industries this bill HELPS

Project 2025 Policy Matches

This bill shows semantic similarity to the following sections of the Project 2025 policy document.AI-enhanced analysis provides detailed alignment ratings.

Department of Health and Human Services

Very Strong
Vector: 63%
Pages: 530-532AI Enhanced

AI Analysis:

"The bill directly reauthorizes and enhances HHS-administered rural health grant programs to increase access to quality care for underserved rural populations, which aligns precisely with the HHS strategic goal of protecting and strengthening equitable access to high-quality, affordable healthcare."

Key themes:rural healthunderserved populationsequitable accessHHS grant programscommunity involvement

— 498 — Mandate for Leadership: The Conservative Promise ENDNOTES 1. U.S. Department of Health and Human Services, Strategic Plan, FY 2018–2022, p. 50, https://aspe.hhs.gov/ sites/default/files/documents/feac346aca967bfadc446398679e14ec/hhs-strategic-plan-fy-2018-2022.pdf (accessed February 7, 2023). 2. “Strategic Goal 1: Protect and Strengthen Equitable Access to High Quality and Affordable Healthcare” in ibid. “In the context of HHS, this Strategic Plan adopts the definition of underserved communities listed in Executive Order 13985: Advancing Racial Equity and Support for Underserved Communities through the Federal Government to refer to ‘populations sharing a particular characteristic, as well as geographic communities, who have been systematically denied a full opportunity to participate in aspects of economic, social, and civic life’; this definition includes individuals who belong to underserved communities that have been denied such treatment, such as Black, Latino, and Indigenous and Native American persons, Asian Americans and Pacific Islanders and other persons of color; members of religious minorities; lesbian, gay, bisexual, transgender, and queer (LGBTQ+) persons; persons with disabilities; persons who live in rural areas; and persons otherwise adversely affected by persistent poverty or inequality. Individuals may belong to more than one underserved community and face intersecting barriers. This definition applies to the terms underserved communities and underserved populations throughout this Strategic Plan.” Ibid. Emphasis in original. 3. Karen Weintraub, “Americans’ Life Expectancy Continues to Fall, Erasing Health Gains of the Last Quarter Century,” USA Today, December 22, 2022, https://www.usatoday.com/story/news/health/2022/12/22/us-life- expectancy-continues-fall-erasing-25-years-health-gains/10937418002/ (accessed February 6, 2023). 4. Apoorva Mandavilli, “The C.D.C. Isn’t Publishing Large Portions of the Data It Collects,” The New York Times, updated February 22, 2022, https://www.congress.gov/117/meeting/house/114450/documents/HHRG-117- IF02-20220302-SD004.pdf (accessed March 22, 2023). 5. Zachary B. Sluzala and Edmund F. Haislmaier, “Lessons from COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing,” Heritage Foundation Backgrounder No. 3696, March 28, 2022, https://www. heritage.org/public-health/report/lessons-covid-19-how-policymakers-should-reform-the-regulation-clinical. 6. U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, “Centers for Disease Control and Prevention (C),” https://www.cdc.gov/maso/pdf/cdcmiss.pdf (March 16, 2023). 7. Judith Garber, “CDC ‘Disclaimers’ Hide Financial Conflicts of Interest,” Lown Institute Accountability Blog, November 6, 2019, https://lowninstitute.org/cdc-disclaimers-hide-financial-conflicts-of-interest/ (accessed February 6, 2023). See also U.S. Department of Health and Human Services, Centers for Disease Control and Prevention, “CDC Foundation Active Programs (October 1, 2014–September 30, 2015),” https://www. cdcfoundation.org/sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2015.pdf (accessed February 7, 2023); “CDC Active Programs (October 1, 2015–September 30, 2016),” https://www.cdcfoundation. org/sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2016.pdf (accessed February 7, 2023); “CDC Foundation Active Programs (October 1, 2016–September 30, 2017),” https://www.cdcfoundation.org/ sites/default/files/upload/pdf/CDCFoundation-ActivePrograms-FY2017.pdf (accessed February 7, 2023); “CDC Foundation Active Programs (October 1, 2017–September 30, 2018),” https://www.cdcfoundation.org/sites/default/ files/upload/pdf/CDCFoundation-ActivePrograms-FY2018.pdf (accessed February 7, 2023); “CDC Foundation Active Programs, October 1, 2018–September 30, 2019,” https://www.cdcfoundation.org/sites/default/files/upload/ pdf/CDCFoundation-ActivePrograms-FY2019.pdf (accessed February 7, 2023); “CDC Foundation Active Programs, October 1, 2029–September 30, 2020,” https://www.cdcfoundation.org/CDCF-ActivePrograms-CDC-FY20?inline (accessed February 7, 2023); and “CDC Foundation Active Programs, October 1, 2020–September 30, 2021,” https://www.cdcfoundation.org/CDCF-ActivePrograms-CDC-FY21?inline (accessed February 7, 2023). 8. Joel White and Doug Badger, “In Order to Defeat COVID-19, the Federal Government Must Modernize Its Public Health Data,” Heritage Foundation Backgrounder No. 3527, September 3, 2020, https://www.heritage. org/sites/default/files/2020-09/BG3527_0.pdf. 9. S. 15, Ensuring Accurate and Complete Abortion Data Reporting Act of 2023, 118th Congress, introduced January 23, 2023, https://www.congress.gov/118/bills/s15/BILLS-118s15is.pdf (accessed March 22, 2023), and H.R. 632, Ensuring Accurate and Complete Abortion Data Reporting Act of 2023, 118th Congress, introduced January 30, 2023, https://www.congress.gov/118/bills/hr632/BILLS-118hr632ih.pdf (accessed March 22, 2023). 10. Doug Badger, “How Congress Can Make Real Progress on Drug Prices,” Heritage Foundation Issue Brief No. 5016, December 9, 2019, https://www.heritage.org/sites/default/files/2019-12/IB5016_1.pdf. — 499 — Department of Health and Human Services 11. Sluzala and Haislmaier, “Lessons From COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 12. Ibid. 13. H.R. 5471, Clinical Laboratory Improvement Amendments of 1988, Public Law No. 100-578, 100th Congress, October 31, 1988, https://uscode.house.gov/statutes/pl/100/578.pdf (accessed March 17, 2023). 14. Sluzala and Haislmaier, “Lessons From COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 15. Edmund F. Haislmaier, “Ensuring Americans’ Access to Pharmaceuticals: A Primer and Road Map for Policymakers,” Heritage Foundation Backgrounder No. 3545, October 20, 2020, https://www.heritage.org/ sites/default/files/2020-10/BG3545.pdf. 16. 18 U.S.C. 1461, https://www.law.cornell.edu/uscode/text/18/1461 (accessed March 16, 2023), and 18 U.S.C. 1462, https://www.law.cornell.edu/uscode/text/18/1462 (accessed March 16, 2023). 17. H.R. 1308, Religious Freedom Restoration Act of 1993, Public Law No. 103-141, 103rd Congress, November 16, 1993, https://www.congress.gov/103/statute/STATUTE-107/STATUTE-107-Pg1488.pdf (accessed March 18, 2023). 18. Charles Piller, “Is FDA’s Revolving Door Open Too Wide?” Science, Vol. 361, No. 6397 (July 6, 2018), p. 21, https://www.science.org/doi/epdf/10.1126/science.361.6397.21 (accessed February 6, 2023). 19. Joel Achenbach, “NIH Halts $100 Million Study of Moderate Drinking That Is Funded by Alcohol Industry,” The Washington Post, May 17, 2018, https://www.washingtonpost.com/news/to-your-health/wp/2018/05/17/nih- halts-controversial-study-of-moderate-drinking/ (accessed February 6, 2023). 20. Alexander Tin, “Moderna Offers NIH Co-ownership of COVID Vaccine Patent amid Dispute with Government,” CBS News, November 15, 2021, https://www.cbsnews.com/news/moderna-covid-vaccine-patent-dispute- national-institutes-health/ (accessed February 6, 2023). 21. Informed Consent Action Network, “NIH Officials Profiting from COVID-19 Vaccine,” June 3, 2021, https://www. icandecide.org/nih-officials-profiting-from-covid-19-vaccine/ (accessed February 6, 2023). 22. Adam Andrzejewski, “Substack Investigation: Fauci’s Royalties and the $350 Million Royalty Payment Stream HIDDEN by NIH,” Open the Books Substack, May 9, 2022, https://openthebooks.substack. com/p/faucis-royalties-and-the-350-million?utm_source=/profile/24758236-adam-andrzejewski&utm_ medium=reader2&s=w (accessed February 6, 2023). 23. Robert E. Moffit, “Time to Reverse Hospital Market Consolidation,” Heritage Foundation Commentary, January 5, 2022, https://www.heritage.org/health-care-reform/commentary/time-reverse-hospital-market-consolidation. 24. H.R. 3590, Patient Protection and Affordable Care Act, Public Law No. 111-148, 111th Congress, March 23, 2021, https://www.congress.gov/111/plaws/publ148/PLAW-111publ148.pdf (accessed March 16, 2023). 25. Brian J. Miller, Robert E. Moffit, James Ficke, Joseph Marine, and Jesse Ehrenfeld, “Reversing Hospital Consolidation: The Promise of Physician-Owned Hospitals,” Health Affairs Forefront, April 12, 2021, https:// www.healthaffairs.org/do/10.1377/forefront.20210408.980640/ (accessed February 13, 2023). 26. Robert E. Moffit, “Medicare’s Future: Challenges and Opportunities,” testimony before the Special Committee on Aging, U.S. Senate, November 21, 2022, https://www.heritage.org/testimony/medicares-future-challenges- and-opportunities. 27. 42 U.S. Code § 256b, https://www.law.cornell.edu/uscode/text/42/256b (accessed March 16, 2023). 28. H.R. 3590, Patient Protection and Affordable Care Act, § 3022. 29. H.R. 5376, Inflation Reduction Act of 2022, Public Law No. 117-169, 117th Congress, August 16, 2022, https:// www.congress.gov/117/plaws/publ169/PLAW-117publ169.pdf (accessed March 16, 2023). 30. Robert E. Moffit, “Reducing Patient Access to New Medications Is the Left’s Latest Medicare Price-Fixing Scheme,” Heritage Foundation Commentary, July 22, 2022, https://www.heritage.org/medicare/commentary/ reducing-patient-access-new-medications-the-lefts-latest-medicare-price-fixing, and Badger, “How Congress Can Make Real Progress on Drug Prices.” 31. Nina Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net,” Heritage Foundation Backgrounder No. 3604, April 14, 2021, https:// www.heritage.org/sites/default/files/2021-04/BG3604_0.pdf, and Brian C. Blase, “Punishing Conservative States: Payment Cuts to Hospitals Where Federal Spending Is Already Low,” Paragon Health Institute, December 2021, https://paragoninstitute.org/wp-content/uploads/2022/06/Punishing-Conservative-States- HTML.html (accessed February 13, 2023).

Department of Health and Human Services

Strong
Vector: 62%
Pages: 518-520AI Enhanced

AI Analysis:

"Both the bill and the Project 2025 policy emphasize improving healthcare access for underserved rural populations through grant programs and community involvement, showing significant overlap in rural health objectives."

Key themes:rural healthaccess to careunderserved populationscommunity involvementfunding reauthorization

— 486 — Mandate for Leadership: The Conservative Promise 1. Investigate state medical school compliance with the Coats–Snowe Amendment,71 which prohibits discrimination against health care entities that do not provide or undergo training for abortion. 2. Ensure that the Accreditation Council for Graduate Medical Education (ACGME) complies with all relevant conscience statutes and regulations and that states have taken the affirmative steps (for example, by issuing regulations) to assure compliance with Coats–Snowe. 3. Communicate to medical schools that any abortion-related training must be on an opt-in rather than opt-out basis. 4. Require states that receive HHS funds to issue regulations or enter into arrangements with accrediting bodies to comply with the Coats–Snowe Amendment’s prohibition of mandatory abortion training by individuals or institutions. The Coats–Snowe Amendment specifically requires such state regulations or arrangements. l Prioritize funding for home-based childcare, not universal day care. As HRSA’s Early Childhood Health page outlines, “Currently, only about half of U.S. preschoolers are on-track with their development and ready for school. And more than one in four of children (28%) who experience abuse or neglect are under 3 years old.”72 Concurrently, children who spend significant time in day care experience higher rates of anxiety, depression, and neglect as well as poor educational and developmental outcomes. Instead of providing universal day care, funding should go to parents either to offset the cost of staying home with a child or to pay for familial, in-home childcare. l Provide education and resources on early childhood health. By partnering with new organizations like the Center on Child and Family Poverty, HRSA should provide resources and information on the importance of the mother–child relationship in child well-being. This should include relationship education curricula that equip mothers and caregivers to connect with and improve their understanding of their infants, toddlers, and young children. Maternal and Child Health. Currently, the HRSA Maternal and Child Health program is collecting data on the benefits of doulas in improving the health, safety, and emotional well-being of mothers at birth. Doulas provide a patient-focused, nonmedical support system for single or married mothers that “decreases the — 487 — Department of Health and Human Services overall cesarean rate by 50%, the length of labor by 25%, the use of oxytocin by 40%, and requests for an epidural by 60%. Doulas often use the power of touch and massage to reduce stress and anxiety during labor.”73 Given concerns about maternal mortality or postpartum depression that is worsened by poor birth experiences, doulas should be an active option for all women whether they are giving birth in a traditional hospital, through midwifery, or at home. Additionally, since most Doulas’ services are not covered by traditional insurance programs, the Maternal and Child Health program should work to pro- vide funding for low-income mothers. INDIAN HEALTH SERVICE (IHS) The Indian Health Service serves our American Indian and Alaska Native popu- lations. Reforms are needed to improve America’s ability to deliver on its promises to these important populations and must take account of cultural preferences and lifestyles, limitations due to geography (such as challenging terrain), and limited Internet access. For example, contacting individuals within some of these com- munities and tribes during the COVID-19 pandemic proved to be difficult because many had transient addresses and unreliable cell service. During the transition to the Biden Administration, IHS abandoned tribes as their sources of COVID-19 tests and vaccine supplies disappeared. It is important to guard against such situations in order to preserve these tribes’ access to health resources during public health emergencies (PHEs). Even before the pandemic, services available to these populations through federal resources and personnel (such as vision care) were often scarce or nonexistent. Patients in these populations should be empowered to rely on alternatives to IHS through better access to private health care providers. Exploring positive reforms contained in the VA MISSION Act74 could reveal similar opportunities for increased options and access for American Indians and Alaska Natives. RURAL HEALTH A growing concern is the decreasing access to health care services for Americans living in rural, less populated areas. Many find themselves in regions that were not previously as rural as industries move away, taking with them economic prosperity and often medical providers. Others are in essential professions such as farming that by nature necessitate living in regions with fewer city accommodations and economic opportunities. Seeking space for one’s family and cultivating the land are valued goals that are deeply rooted in America’s fabric. Both Congress and an Administration must continually keep in mind how health care policies uniquely affect these regions because their market trends and populations are different from those of more populous regions. Often, rural patients face an hour’s drive to the nearest medical provider or facility or have

Department of Health and Human Services

Moderate
Vector: 63%
Pages: 533-535AI Enhanced

AI Analysis:

"The bill focuses on improving rural healthcare access through grant programs and community involvement, which aligns broadly with Project 2025's emphasis on healthcare reform and state/local flexibility, though it does not directly reference Medicaid reform, managed care oversight, or specific conservative policy levers outlined in the HHS section."

Key themes:healthcare accessrural healthcommunity engagementgrant programsHHS administration

— 500 — Mandate for Leadership: The Conservative Promise 32. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 33. Brian Blase, “Managed Care in Medicaid: Need for Oversight, Accountability, and Reform,” Paragon Health Institute Policy Brief, October 13, 2022, https://paragoninstitute.org/wp-content/uploads/2022/10/20221012- Managed-Care-in-Medicaid-Need-for-Oversight-Accountability-and-Reform-FOR-DISTRIBUTION-V2.pdf (accessed February 13, 2023). 34. Owcharenko Schaefer, “Medicaid at 55: Understanding the Design, Trends, and Reforms Needed to Improve the Health Care Safety Net.” 35. 42 U.S. Code § 1315, https://www.law.cornell.edu/uscode/text/42/1315 (accessed March 17, 2023). 36. Chad D. Savage and Lee S. Gross, “Direct Primary Care: Update and Road Map for Patient-Centered Reforms,” Heritage Foundation Backgrounder No. 3635, June 28, 2021, https://www.heritage.org/sites/default/ files/2021-06/BG3635.pdf. 37. H.R. 133, Consolidated Appropriations Act, 2021, Public Law No. 116-260, 116th Congress, December 27, 2020, Division BB, Title I, https://www.congress.gov/116/plaws/publ260/PLAW-116publ260.pdf (accessed March 17, 2023). 38. Doug Badger, “On Surprise Medical Bills, Congress Should Side with Consumers, Not Special Interests,” Heritage Foundation Commentary, January 31, 2020, https://www.heritage.org/health-care-reform/ commentary/surprise-medical-bills-congress-should-side-consumers-not-special. 39. Edmund F. Haislmaier and Abigail Slagle, “Premiums, Choices, Deductibles, Care Access, and Government Dependence Under the Affordable Care Act: 2021 State-by-State Review,” Heritage Foundation Backgrounder No. 3668, November 2, 2021, https://www.heritage.org/sites/default/files/2021-11/BG3668.pdf. 40. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, “Transparency in Coverage,” Final Rule, Federal Register, Vol. 85, No. 219 (November 12, 2020), pp. 72158–72310, https://www.govinfo.gov/ content/pkg/FR-2020-11-12/pdf/2020-24591.pdf (accessed March 17, 2023). 41. David N. Bernstein and Robert E. Moffit, “New Price Transparency Rule Will Help Transform America’s Health Care System,” Heritage Foundation Commentary, November 1, 2020, https://www.heritage.org/health-care- reform/commentary/new-price-transparency-rule-will-help-transform-americas-health-care. 42. Sluzala and Haislmaier, “Lessons from COVID-19: How Policymakers Should Reform the Regulation of Clinical Testing.” 43. Ibid. 44. Most recently enacted in H.R. 2471, Consolidated Appropriations Act, 2022, Public Law No. 117-103, 117th Congress, March 15, 2022, Division H, Title V, §§ 506–507, https://www.congress.gov/117/plaws/publ103/ PLAW-117publ103.pdf (accessed March 17, 2023). 45. President Joseph R. Biden Jr., Executive Order 14079, “Securing Access to Reproductive and Other Healthcare Services,” August 3, 2022, in Federal Register, Vol. 87, No. 154 (August 11, 2022), pp. 49505–49507, https:// www.govinfo.gov/content/pkg/FR-2022-08-11/pdf/2022-17420.pdf (accessed March 16, 2023). 46. Planned Parenthood, 2020–2021 Annual Report, p. 27, https://www.plannedparenthood.org/uploads/ filer_public/40/8f/408fc2ad-c8c2-48da-ad87-be5cc257d370/211214-ppfa-annualreport-20-21-c3-digital.pdf (accessed March 22, 2023). 47. Ibid., pp. 30 and 31. Total revenue of $1,714.4 million (p. 30) minus $1,580.7 million in total expenses (p. 31) yields $133,7 million. 48. Ibid., p. 28. 49. Ibid., p. 30. 50. H.R. 372, Protecting Life and Taxpayers Act of 2023, 118th Congress, introduced January 17, 2023, https://www. congress.gov/118/bills/hr372/BILLS-118hr372ih.pdf (accessed March 17, 2023). 51. 42 U.S. Code § 18023, https://www.law.cornell.edu/uscode/text/42/18023 (accessed March 17, 2023). 52. H.R. 3128, Consolidated Omnibus Budget Reconciliation Act of 1985, Public Law No. 99-272, 99th Congress, April 7, 1986, Title IX, Subtitle A, Part 1, Subpart B, § 9121, https://www.congress.gov/99/statute/STATUTE-100/ STATUTE-100-Pg82.pdf (accessed March 17, 2023). 53. H.R. 8070, Rehabilitation Act of 1973, Public Law No. 93-112, 93rd Congress, September 26, 1973, https://www. congress.gov/93/statute/STATUTE-87/STATUTE-87-Pg355.pdf (accessed March 17, 2023). — 501 — Department of Health and Human Services 54. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, Office of Civil Rights, and Office of the Secretary, “Special Responsibilities of Medicare Hospitals in Emergency Cases and Discrimination on the Basis of Disability in Critical Health and Human Service Programs or Activities,” draft of Proposed Rule, January 14, 2021, https://www.hhs.gov/sites/default/files/infants-nprm.pdf (accessed March 17, 2023). 55. H.R. 26, Born-Alive Abortion Survivors Protection Act, 118th Congress, introduced January 9, 2023, https:// www.congress.gov/118/bills/hr26/BILLS-118hr26pcs.pdf (accessed March 17, 2023). 56. H.R. 7, No Taxpayer Funding for Abortion and Abortion Insurance Full Disclosure Act of 2023, 118th Congress, introduced January 9, 2023, https://www.congress.gov/118/bills/hr7/BILLS-118hr7ih.pdf (accessed March 17, 2023). 57. S. 401, Conscience Protection Act of 2021, 117th Congress, introduced February 24, 2021, https://www.congress. gov/117/bills/s401/BILLS-117s401is.pdf (accessed March 17, 2023). 58. U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, and Office of the Secretary, “Nondiscrimination in Health Programs and Activities,” Notice of Proposed Rulemaking; Notice of Tribal Consultation, Federal Register, Vol. 87, No. 149 (August 4, 2022), pp. 47824–47920, https://www.govinfo. gov/content/pkg/FR-2022-08-04/pdf/2022-16217.pdf (accessed March 17, 2023). 59. Ibid., p. 47916. 60. The regulation was not finalized before the end of the Administration. U.S. Department of Agriculture, Food and Nutrition Services, “Revision of Categorical Eligibility in the Supplemental Nutrition Assistance Program (SNAP),” Proposed Rule, Federal Register, Vol. 84, No. 142 (July 24, 2019), pp. 35570–55581, https:// www.federalregister.gov/documents/2019/07/24/2019-15670/revision-of-categorical-eligibility-in-the- supplemental-nutrition-assistance-program-snap (accessed March 17, 2023). 61. 45 Code of Federal Regulations § 75.300(c) and (d), https://www.ecfr.gov/current/title-45/subtitle-A/ subchapter-A/part-75/subpart-D/subject-group-ECFR911e5e1a30bfbcb/section-75.300 (accessed March 17, 2023). 62. H.R. 1750, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https:// www.congress.gov/117/bills/hr1750/BILLS-117hr1750ih.pdf (accessed March 17, 2023), and S. 656, Child Welfare Provider Inclusion Act of 2021, 117th Congress, introduced March 10, 2021, https://www.congress.gov/117/bills/ s656/BILLS-117s656is.pdf (accessed March 17, 2023). 63. S. 3949, Trafficking Victims Protection Reauthorization Act of 2022, Public Law No. 117-348, 117th Congress, January 25, 2023, https://www.congress.gov/117/plaws/publ348/PLAW-117publ348.pdf (accessed March 17, 2023). 64. Kelsey Y. Santamaria, “Child Migrants at the Border: The Flores Settlement Agreement and Other Legal Developments,” Congressional Research Service In Focus No. IF11799, April 1, 2021, https://crsreports.congress. gov/product/pdf/IF/IF11799 (accessed March 17, 2023). 65. Report, Building a Happy Home: Marriage Education as a Tool to Strengthen Families, Social Capital Project Report No. 1-22, March 2022, p. 17, https://www.jec.senate.gov/public/_cache/files/3d102525-6f0d-48ed- 92f4-d71edd468ad6/building-a-happy-home.pdf (accessed March 17, 2023). The cover of the report reflects that the Social Capital Project is “[a] project of the Joint Economic Committee – Republicans.” 66. See, for example, Alan J. Hawkins, “Are Federally Supported Relationship Education Programs for Lower-Income Individuals and Couples Working? A Review of Evaluation Research,” American Enterprise Institute, September 2019, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 67. H.R. 8404, Respect for Marriage Act, Public Law No. 117-228, 117th Congress, December 13, 2022, https://www. congress.gov/117/plaws/publ228/PLAW-117publ228.pdf (accessed March 17, 2023). 68. Madison Marino, “Over 1,000 Safety Violations Mar Head Start. Children Deserve Better,” Heritage Foundation Commentary, November 10, 2022, https://www.heritage.org/education/commentary/over-1000-safety- violations-mar-head-start-children-deserve-better. 69. American Hospital Association v. Becerra, 596 U.S. ___ (2022), https://www.supremecourt.gov/ opinions/21pdf/20-1114_09m1.pdf (accessed March 17, 2023). 70. U.S. Department of the Treasury, Internal Revenue Service; U.S. Department of Labor, Employee Benefits Security Administration; and U.S. Department of Health and Human Services, Centers for Medicare and Medicaid Services, “Coverage of Certain Preventive Services Under the Affordable Care Act,” Notice of Proposed Rulemaking, Federal Register, Vol. 88, No. 22 (February 2, 2023), pp. 7236–7281, https://www. govinfo.gov/content/pkg/FR-2023-02-02/pdf/2023-01981.pdf (accessed March 17, 2023).

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Policy matches are calculated using a hybrid approach: initial candidates are found using semantic similarity between bill summaries and Project 2025 policy text, then an AI model (Llama 3.1 70B) provides detailed alignment ratings and analysis. Ratings range from 1 (minimal alignment) to 5 (very strong alignment). This analysis does not imply direct causation or intent.

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