Grassley Op-Ed: Protecting Rural Health and Housing

As one of only two farmers serving in the U.S. Senate, I’ve continuously made it a priority to tackle the challenges facing Iowans in rural communities. Access to high-quality and affordable health care, child care and housing are among the top concerns I hear from Iowans – particularly in rural areas – during my annual meetings in each of the state’s 99 counties. That’s why I’ve recently introduced bills to protect rural hospitals, improve access to affordable child care and preserve valuable housing resources.

 

Not only do small town hospitals often provide a sole source of health care for rural Iowans, but they also serve as an important source of jobs in their communities. In fact, a study on the economic impact of rural health care found that, on average, 14 percent of jobs in our small towns are related to health care. Yet a number of factors have made it more difficult for rural hospitals to keep their doors open for patients.

 

I’ve introduced bipartisan legislation, known as the Rural Hospital Support Act, which seeks to provide rural hospitals with much-needed financial stability and security by permanently extending two key Medicare programs. The programs, known as Medicare-Dependent Hospital (MDH) and Low-Volume Hospital (LVH) designations, offer a safety net for rural health care providers and are extremely important to rural economies. I’ll continue working to ensure rural hospitals can provide quality health care at a rate that competes well with urban hospitals.

 

In addition to protecting health care access, I’ve successfully pushed the Biden administration to continue allowing Iowans to purchase transitional health insurance plans – plans that were purchased after the Affordable Care Act (ACA) became law in 2010, but before it was formally implemented in 2013. These plans protect individuals with pre-existing conditions from discrimination. Over 58,000 Iowa farmers, small business owners and their families currently access high-quality and affordable health insurance through this popular ACA carve out, so I’m pleased the administration listened to my request.

 

While I’m working to protect health care and access to insurance for adults and seniors, I’m also focused on expanding access to quality, affordable child care for families. I’ve heard from many Iowa families – whose pocketbooks are stretched thin from soaring gas and grocery prices – concerned about child care costs. With inflation hovering around a 40-year high, the last thing families need to worry about is not being able to afford child care. I’ve joined several of my colleagues in putting forward a proposal: the Child Care and Development Block Grant (CCDBG) Reauthorization Act.

 

This legislation builds on 30 years of bipartisan work on this issue by making responsible enhancements to the existing child care assistance grant program. Instead of completely rewriting the playbook and creating new top-down entitlement programs, our proposal would expand eligibility for this successful program that empowers parents, while also improving reimbursement rates. Additionally, it removes unnecessary regulations that restrict home-based child care providers in rural areas to keep child care costs low for hardworking families. Ensuring child care is widely available and affordable will continue to be a top priority of mine.

 

Senator Ernst and I have teamed up to tackle another issue that I hear about from communities across Iowa: access to affordable housing. Our Rural Housing Accessibility Act seeks to protect resources intended for low-income families in Iowa from being redirected to major cities, like Chicago. Recently, residents of major cities – who face much longer wait times for affordable housing vouchers – have come to Iowa to apply for and receive these vouchers, only to quickly move back to their home states. Under current law, they take their Iowa vouchers with them, meaning fewer resources for Iowans and a sunk cost for taxpayers. In 2020, the Iowa City Housing Authority found that 1,798 vouchers were lost, totaling $1.2 million; and in 2021, the Sioux City Housing Authority paid just under $200,000 to 13 families who had moved to Illinois, Minnesota and other states. Simply put, our bill would ensure Iowans have access to affordable housing resources intended for communities in Iowa.

 

I’m always looking for ways to boost opportunities and encourage young adults to live, work and raise their families in our rural communities. By strengthening our health care, child care and housing systems and programs, I’m working to ensure rural Iowa will continue to grow and prosper for generations to come.