Democrats Slam GOP’s Rural Health Push As ‘Damage Control’ Amid Growing Backlash To Medicaid Cuts

House Energy & Commerce Republicans held a hearing Wednesday (July 16) to discuss a series of bills aimed at strengthening rural health care -- an effort that committee Democrats told Inside Health Policy is nothing more than damage control amid mounting backlash over the GOP’s near $1 trillion Medicaid cut in their recently passed reconciliation package.

“We’ve been talking about a bill that helps staff rural areas, which I suppose tries to make up for some of what the administration did with DOGE and also with the big, ugly bill that cut Medicaid,” Rep. Kim Schrier (D-WA) said in a hallway interview with IHP during the hearing. “So, it will not make up for the damage that my Republican colleagues have just done; it shows that they feel guilty about it, and they know that it was a bad bill.”

The rural health-focused hearing came the same week Sen. Josh Hawley (R-MO) introduced a bill to reverse several provisions of the GOP’s so-called One Big Beautiful Bill Act, despite having voted for it. Hawley’s bill would repeal the cap on states’ provider taxes, lift restrictions on state-directed payments, and boost the Rural Health Transformation Program by adding $10 billion annually from 2031 to 2035 -- bringing total funding to $100 billion over 10 years.

During her opening statement, E&C health subcommittee ranking Democrat Diana DeGette (CO) condemned the reconciliation bill for stripping health coverage from millions and adding trillions to the national deficit, pointing to Hawley’s new proposal as proof that even Republicans want to “clean up this mess of a law before it hurts more people.”

“Much of it won’t go into effect for years, so I hope that we could work together in a bipartisan way to clean up this mess of a law before it hurts more people, and apparently so does Sen. Hawley, who after voting for the law just two weeks ago, introduced a bill that would reverse many of the cuts to Medicaid that he just voted for,” DeGette said.

“I pride myself on working in a bipartisan way on bills that would improve the health of our constituents and all Americans, but I feel -- and all my colleagues on this subcommittee feels -- that we’ve been frozen out of the work of this subcommittee from the beginning of the year, from issues that should be non-controversial to the big bad bill that we just passed a couple of weeks ago,” DeGette added.

Hawley’s bill has sparked questions on Capitol Hill about whether, if Republicans move to scale back some of the Medicaid cuts in their newly enacted megabill, Democrats will get on board. DeGette’s opening statement suggested Democrats may be open to bipartisan efforts to plug up some holes in the law -- but when asked by IHP, committee Democrats stopped short of committing to support GOP-led proposals to revise or roll back specific provisions.

“I’d want to see what the bills look like,” Schrier said.

“I’m just going to keep telling people the truth about what this health care bill is and how broken our health care is,” Rep. Debbie Dingell (D-MI) told IHP in a hallway interview during the hearing.

At the same time, while Hawley appears eager to revise parts of the bill, it remains unclear whether he has enough support in the Senate or whether House Republicans are willing to entertain his proposed changes at all.

When IHP asked whether E&C Republicans are in talks to make similar tweaks, Rep. Troy Balderson (R-OH) responded simply, “Not that I’m aware of, no.”

No Republicans mentioned Hawley’s bill during the hearing, however, and Rep. Michael Rulli (R-OH) instead praised the $50 billion rural health fund included in the reconciliation package, calling it a “profound” investment in rural health care.

“There is a major problem in this country with rural hospitals that we have to fix, and it is something that every elected official that is brought onto the Hill to try to do,” Rulli said. “On the heels of the big beautiful historical bill, contrary to popular belief, there is a $50 billion investment in rural health care. This is what happens when you get to the finish line of any piece of legislation and the two parties and everyone starts working together.”

“We realized there was a hole with the rural hospitals, and we got $50 billion of investment in rural health care, which will have a profound impact,” he added.

The rural health fund has faced growing criticism from advocates, lobbyists, and health care experts since the bill’s passage, with many warning it falls short of addressing the damage caused by the broader reconciliation package. According to health care regulatory experts at the PYA Center for Rural Health Advancement, accessing the rural health fund won’t be easy for states, which must submit complex rural transformation plans to CMS by the end of the year despite little clarity on how the agency will evaluate or approve them.

In an emailed statement to IHP on Wednesday, the experts also flagged several structural issues: tight timelines to spend the money or risk forfeiture, rigid spending rules, and a funding formula that splits half the money equally across all states regardless of actual need. They also criticized the vague criteria for distributing the remaining funds and noted that states have no right to appeal CMS decisions if funding is denied or later recouped.

Experts warn the massive Medicaid cuts in the so-called One Big Beautiful Bill Act could force already struggling rural hospitals to shut down, despite the inclusion of the $50 billion rural health fund. They’ve said that new restrictions on provider taxes could cut off a key source of indirect financial support for rural hospitals already operating on razor-thin margins, while limits on state-directed payments may hinder states’ ability to strategically direct Medicaid funds to struggling providers.

On top of that, with the bill expected to strip coverage from up to 17 million Americans through tighter eligibility rules and work requirements, rural hospitals would likely see a surge in uninsured patients unable to pay for care, fueling spikes in uncompensated care that these facilities are least equipped to handle.