Recognizing National Rural Health Day

Floor Speech

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Mr. COSTA. Madam Speaker, I thank Congressman O'Halleran for leading this Blue Dog Special Order on a very important issue affecting rural America.

The Blue Dogs, obviously, represent the breadth and width and diversity of our country, but many of us represent rural areas. Healthcare for every American is a critical need, a critical issue.

In 2010, before the Affordable Care Act became law, in the district that I represent in California, in the San Joaquin Valley, 22 percent of my constituents had no healthcare insurance whatsoever, and 17 percent were underinsured.

The Affordable Care Act has a number of areas where we could provide improvements if we could get bipartisan agreement, but the fact is that we have the ability to protect individuals who have preexisting conditions; children can be on their parents' healthcare insurance until the age of 25; things have really expanded with Medicaid and Medicare; and, what often gets overlooked, $8 billion was provided in the Affordable Care Act for rural healthcare clinics across America.

What does this mean in my district, a district that represents one of the richest agricultural regions in the entire country and the world? We have gone, in 9 years, from 22 percent underinsured to 10 percent underinsured. We have cut the number of people who have no insurance by more than half. We have reduced the level of those who are underinsured.

In addition, clinics in my area, Camarena, Livingston, Golden Valley, Clinica Sierra, to mention at least four or five, have all expanded their rural healthcare clinics to provide more healthcare for people who live in rural areas, from prenatal to elderly and everything in between.

In addition, they have done innovative things like other clinics across America. They have put healthcare clinics in high schools and middle schools, which has provided greater access to healthcare.

We have made a difference. We have improved the level of healthcare. But the reality is this: For three decades, the number of hospitals in rural areas in our country has declined at a steep pace. Among the 50 rural hospitals in California, more than a dozen have closed since the early 2000s.

It also has been devastating not only to the level of healthcare but to the residents who live in those communities, hardworking people who contribute to our economy every day, part of our farm communities.

I think it is important to note that for every 1,000 people in the place I live, we have 0.9 physicians. Anywhere else in California, for every 1,000 people, there are 2.2 physicians, twice as many physicians.

While this is an important part of improving healthcare, we also need to get medical schools. That is something that I have worked on. I have worked on trying to get additional medical schools not only across the country but in the San Joaquin Valley.

We know that if you get a medical school there, it provides an opportunity for students who graduate from that medical school to practice in the area in which they have graduated.

We have proof of that. We have residency programs that I have been very supportive of with the University of California, San Francisco, UCSF, which has over 280 residents who are being trained in the valley right now. Over half of those physicians over the last 40 years who have graduated from that residency program have stayed to practice in our valley. So a medical school is an important part of an overall strategy.

As Blue Dogs, we want to continue to support expanded healthcare throughout our rural areas. This is something I believe Democrats and Republicans can come together on in a bipartisan manner.

These are many ways in which we can work to ensure that rural America gets reliable, affordable healthcare that they deserve, like every other American. That is why Blue Dogs are speaking out on this issue today.

Since taking office, this administration, sadly, has made repeated efforts to eliminate the Affordable Care Act without putting anything in its place. That makes no sense. That makes no sense whatsoever.

Just this week, we voted on a continuing resolution to keep government open for the next 6 weeks. We should have a real budget in place at this time. It is irresponsible to ever, as the President did earlier this year, shut down government. But in this continuing resolution, we have funding to ensure that our community health centers keep receiving the funding they need to stay open and serve their patients.

This year alone, Congress has voted on 10 different proposals to improve healthcare and stabilize the Affordable Care Act for American families. They are over in the Senate right now. Sadly, instead of taking action, Senator Mitch McConnell refuses to bring up these good measures.

We could be lowering the cost of prescription drugs, which affects all Americans, whether you live in rural areas or urban areas, and ensuring that we protect those who have preexisting conditions, preexisting conditions of heart disease, cancer, diabetes.

These bills, sadly, are collecting dust on the majority leader's desk.

I want to close by saying, as a 15-year member of the Blue Dog Coalition, our caucus stands together to try to improve healthcare for all Americans.

For those of us who represent rural America, like Congressman O'Halleran, myself, and many others, it is important to note that we must improve our healthcare system for the people who live in our rural areas.

It is time for the Senate to do their job and pass these important bills.

We will continue to work to try to expand access to healthcare in rural areas with our clinics and to create medical schools in areas that are significantly underserved.

While we continue to patiently ask the Senate to act, I know the Blue Dogs will continue to advocate for policies that improve access to healthcare for all Americans, especially for those rural Americans we represent.

Madam Speaker, I thank the gentleman for his leadership in this important area as the legislative chair for the Blue Dog caucus. The citizens of Arizona are fortunate to have a good Representative.

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Mr. COSTA. Madam Speaker, I thank the gentleman again, and I wish him a happy Thanksgiving.

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