The 2010 Affordable Care Act included some important provisions to increase the number of physicians serving rural areas across the nation. But Congress must act soon to keep the money flowing into these vital programs.
One of the programs funded by the ACA created residencies in rural areas typically underserved by physicians. Since 2011, the Teaching Health Centers program has awarded more than $6 million health and dental clinics in rural communities in Washington state. It’s helped pay for 28 primary-care doctors each year who are completing their residency requirements in places such as Toppenish, Puyallup and Yakima, working with rural, low-income and minority communities where health care is stretched thin.
But funding for the Teaching Health Center ends next year.
The Affordable Care Act also raised Medicaid reimbursements for primary-care doctors who typically earn far less than specialists. The disparity in pay between specialists and family care physicians is one reason only one out of three doctors practice family or primary-care medicine. Studies have shown that overall health would improve with a 50-50 ratio of specialists to primary-care doctors.
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Funding for this program ends this year.
That’s unacceptable. The Affordable Care Act has made the dream of better health care more attainable to millions of people who now have medical insurance. But what good is medical insurance if the would-be patients can’t find a doctor?
Add in baby boomer demand for health care and a slew of doctors reaching retirement age. Suddenly, the doctor shortage, especially in rural areas, is a medical crisis in the making.
That’s why it’s incumbent upon Congress to infuse the programs born out of the ACA with new money. A bill introduced by Sen. Patty Murray, D-Wash., would extend the residency program for rural America until 2019 at a cost of $420 million. Beginning in 2019, a slight decrease in Medicare reimbursements to teaching hospitals would be used to finance the residency program.
Another important program to keep funding is the National Health Services Corps, which also got a boost from the Affordable Care Act. Doctors who enroll in the program to practice in areas that have a shortage of doctors receive help paying back their school loans.
Another innovative idea that deserves support is the Targeted Rural and Underserved Track, or TRUST program at the University of Washington School of Medicine. The school recruits students from rural areas and helps train physicians to provide health care in underserved communities.
It takes a special kind of person to be a rural doctor. The long hours and rural lifestyle aren’t for everyone. But there are rewards as well, knowing the care provided is improving the overall health and well-being of the community.
The federal government and medical schools must continue to play proactive roles in assuring rural health care is not just affordable, but accessible, too.