Ranking Member DeLauro Statement at Addressing the Challenges of Rural America Hearing

Congresswoman Rosa DeLauro (D-CT-03), Ranking Member of the House Appropriations Committee and the Labor, Health and Human Services, Education, and Related Agencies Appropriations Subcommittee delivered the following remarks at the Subcommittee's hearing on challenges of rural America:

Thank you very much, Mr. Chairman, for holding this hearing. It is a critical and important hearing. I want to say a thank you to the agency officials and outside experts joining us today:

First panel:

• Deputy Assistant Secretary Jacobs-Simmons;
  Associate Administrator Tom Morris;
  Deputy Assistant Secretary Ruth Ryder;

Second panel:

• Dr. Carrie Cochran-McClain;
• Dr. Tearsanee Davis;
• Ms. Laura Scheibe;
• and Dr. Brittany Hott.

Thank you all very much for helping us lay out the issues that are critical and important to rural America.

I look forward to taking a closer look at the programs in the Departments of Labor, Health and Human Services, and Education that serve rural America. Our rural communities are integral to our national economy, to our history, to our identity. About one-fifth of all Americans live in rural parts of the country. Unfortunately, the challenges these communities face are too often overlooked and poorly understood. Addressing these enduring issues and advancing equity and opportunity for people in rural areas is something I care deeply about. Connecticut has larger cities, but we do have very rural communities in our state as well.

Rural Americans are more likely to die of chronic illnesses than their urban counterparts. Rural communities have higher childhood and adult poverty rates, less access to health care, and are less likely to have health insurance. In reviewing your testimony, I noted from two of our witnesses, Dr. Cochran-McClain and Associate Administrator Morris, that since 2010, 147 rural hospitals have closed. In the United States, the wealthiest nation in the world, millions of people cannot get the health care they need. This is unacceptable. Beyond healthcare, accessing child care is more difficult in rural areas, as is accessing higher education and finding a job.

And Dr. Hott, as you mention in your testimony, almost 17 percent of your rural students live below the poverty line and nearly 15 percent qualify for special education services. Teachers lack the resources and support they need to do their. On top of that, nearly 40 percent of rural students have inadequate internet access at home.

And on top of all of this, rural families also struggle with the same challenges all working class and underserved families face. They are living paycheck to paycheck with jobs that do not pay them enough and costs that are too high. And they have not seen their wages increased in years. They personally feel the impacts of our most urgent health crises, including the epidemics of opioid and substance use disorders, unconscionable rates of maternal mortality, chronic diseases, and the mental health crisis.

Because these obstacles impact the health and financial wellbeing of our rural communities so intensely, this Committee has made great strides to increase funding for the targeted programs that support the health, safety, and prosperity of rural areas.

As you know, we increased funding for Rural Health Programs that specifically address rural communities’ most pressing health crises. This includes the Rural Communities Opioid Response Program that fights substance use and provides often-lifesaving support to people who are in desperate need. We also created the Rural Emergency Hospitals Technical Assistance Program to better support rural hospitals and the people they serve. And to safeguard the health of women and mothers at a time when more than half of all rural counties lack hospital obstetrics services and maternal mortality rates are simultaneously rising, we strengthened the Rural Maternity Obstetrics Management Program (“R-MOMS”) to meet this critical, but unmet need in rural areas.

To increase the quality of and access to good educational opportunities for rural schools, we strengthened the Rural Education Achievement Program to increase the capacity of school districts to serve students. At the same time, we funded large formula grants that serve students everywhere, including rural students. These include increases for Title I grants that provide Department of Education funding to support low-income students in our nation’s public schools and IDEA grants that support students with disabilities across the country, recognizing the great needs that rural communities in our country face.

And to help workers and working families, we improved job training program grants that help workers in rural areas gain the skills they need to succeed in their jobs.

The programs we fund in this bill have the capacity to drastically improve people’s lives at every stage of their life. And we must do more.

We must fund high-quality schools and childcare to grow opportunity for children and families. We must support high-quality job training programs and apprenticeships to help workers re-enter the workforce or find a better-paying job. We must fund the health programs that improve access to life-saving health care and prevent or treat chronic illnesses. And as Dr. Tearsanee Davis makes clear, to make sure health care is more accessible for families, we must increase our support for telehealth programs and other critical tools that keep people connected to and accessing the health care they need. As you mention in your testimony, Mr. Morris, Medicare fee for service telehealth visits went from less than 1 million in 2019 to more than 50 million in 2020. Investing in telehealth has never been more important. This is a key way we can continue to fight unacceptable and dangerous health disparities.

I am concerned that rural communities will suffer the brunt of the impact if the Majority moves forward with their plan to roll back spending to the 2022 level. As you might know, I received letters from agency heads, including at DOL, HHS, and ED, outlining the impact that these cuts would have. Let me run through some of the ones that would most impact rural children and families:

• Cuts to the Department of Education would remove more than 100,000 teachers and service providers from classrooms serving low-income students and students with disabilities funded through Title I and IDEA grants.
• Cuts to the Department of Labor would cut workforce training and development for 750,000 job seekers.
• Cuts to HHS would result in fewer opioid use disorder and medication-assisted treatment programs that millions of people in rural areas depend on.

These deeply impact rural families. Some people have questioned the approach to analyzing these cuts on the premise that the Republican majority will cut spending, but that these cuts might not be shared equally. The members of this subcommittee know well that if certain other programs are exempt from cuts, health and education programs that working families rely on would be cut by even more than OMB’s current estimates.

This subcommittee can and must do more to lift up our nation’s most vulnerable so that every person, no matter their background or zip code, has the opportunity to contribute, succeed and prosper. This means strengthening the programs we just spoke about, not gutting them.

I again welcome and thank all of our witnesses for testifying here today on what more can be done.

And with that, Mr. Chairman, I yield back.