Becerra says rural health would improve if states expand Medicaid

April 16, 2024

Rural health outcomes would improve if more states expanded Medicaid, Health and Human Services (HHS) Secretary Xavier Becerra told a Senate panel Tuesday. 

During a hearing on the administration’s budget request, Sen. Cindy-Hyde Smith (R-Miss.) said she is particularly worried about maternal care deserts caused by hospital closures. Mississippi sees some of the worst maternal health outcomes in the country, she said, and often leads the country in infant mortality. 

Becerra said telehealth access is crucial, and Congress should ensure the agency’s pandemic-era telehealth flexibilities can continue. Many temporary waivers expire at the end of the year.  

But more than anything, Becerra said, women in Mississippi would be better served if the state expanded Medicaid. 

“Many of the women who are having bad outcomes could have qualified for earlier care had they been eligible for Medicaid,” he said. “I think if we expand Medicaid in some of the states that haven’t yet done it, about a million and a half more Americans, many of them women who want to deliver a baby, would have access to earlier care and not wait until it’s a difficult circumstance in the delivery.” 

Mississippi is one of 10 states that have declined to accept federal money to expand Medicaid under the Affordable Care Act.

State lawmakers appear closer than ever to adopting expansion. But the legislature passed dueling proposals, and a controversial work requirement is a significant barrier, as is the opposition of Gov. Tate Reeves (R).

Becerra was also pressed by Sen. Joe Manchin (D-W.Va.) about why HHS hasn’t yet implemented an anti-addiction law that aims to allow better data sharing, so health providers have all the information necessary to provide medically appropriate care. 

“We are trying to tackle that HIPAA privacy hurdle,” Becerra said, because providers need to understand the new rules.  

But Manchin expressed frustration that the agency hasn’t been moving faster.  

“We thought we crossed every hurdle … it’s just time to implement it. I would implore you, get your staff moving on this one here. We’ve waited a long time for it,” he said.  

Jessie’s Law, passed by Congress in 2018, was named for a recovering addict who died of an opioid overdose when her discharging physician, unaware of her medical history, prescribed oxycodone.  

The law lets doctors access a consenting patient’s prior history of addiction to make fully informed care and treatment decisions. It requires HHS to develop best practices for hospitals and doctors to display a patient’s history of substance use disorder when the patient provides that information.  

“We need the help of providers to make sure they’re getting their personnel to understand the new rules,” Becerra said.  

“Well, I think the quicker you put them out, the quicker they’ll understand them,” Manchin countered.