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Chairman Smith Opening Statement – Field Hearing on Access to Health Care in America: Ensuring Resilient Emergency Medical Care – Denton, Texas

March 18, 2024

“For too many Americans, especially those living in rural or underserved communities, when they call 9-1-1, help may be too far away to reach them in time.”

As prepared for delivery.

“The Ways and Means Committee is in Denton, Texas, for our seventh hearing outside Washington. I’d like to thank Global Medical Response for hosting us today, and giving us the opportunity to see firsthand where you train your pilots, clinicians, and mechanics to respond to emergency situations across the country. 

“One of our priorities is to help every American access quality health care, when they need it, where they need it. Unfortunately, for too many Americans, especially those living in rural or underserved communities, when they call 9-1-1, help may be too far away to reach them in time. That’s because there are no ambulances or emergency health care personnel close by to quickly answer the call. Even after help arrives, the trip to the emergency room, if necessary, may be far too long and too expensive. 

“Today, we will hear the stories of Americans who face challenges accessing emergency care. We will also hear from health care professionals and first responders who rise to meet those challenges and save lives. 

“Across the country, there is a lack of access to emergency care. 82 percent of all U.S. counties contain at least one ambulance desert where patients live more than 25 minutes from an ambulance post. In Texas, it’s even worse. 95 percent of the counties in this state have at least one ambulance desert. 

“This problem is amplified in rural areas, where driving distances are longer and hospitals are further apart. 

“Nearly four and a half million Americans in rural counties do not have ready access to acute care, including emergency care. As a result, rural patients can wait up to 30 minutes for EMS after dialing 9-1-1, when every second counts. 

“We also know that access to emergency care can also be a challenge for those living in urban communities as well. These health facilities frequently must navigate higher volumes of patients with critical emergencies, often stretching hospital staff and resources to the breaking point.

“Once in the emergency room, patients face another challenge. Wait times have doubled since 2020. 

“Hospitals have had to cut emergency room staff to make ends meet as insurance companies are slashing reimbursements. It’s a nasty consequence from the Biden Administration’s flawed implementation of a law Congress passed to ban surprise medical bills. 

“Patients in the ER need help quickly. Back in Washington, the Ways and Means Committee has demanded the Biden Administration implement the No Surprises Act in accordance with congressional intent and the letter of the law. We will continue our oversight work to shine a light on unfair treatment of patients, and ensure Washington bureaucrats follow the laws Congress passes.

“A good doctor would stop the bleeding, and we need to stop the financial bleeding of emergency rooms in small towns.

“One solution is a new designation Congress created under the Trump Administration that helps struggling rural hospitals keep their 24/7 emergency rooms open and offer needed primary care. 

“The Rural Emergency Hospital designation has the chance to be a winning scenario. Patients in surrounding areas get the emergency care they need, low-volume hospitals no longer have the financial pressure to fill beds, and the local economy gets a shot in the arm.

“Texas actually has more Rural Emergency Hospitals than any other state. 

“This designation is off to a promising start, but Congress should continue to bolster this option to make it easier for hospital participation and conversion so that small rural hospitals, and similar facilities can better provide needed emergency care.

“We need to embrace creative solutions that come from the American people affected by these issues and can positively disrupt a broken status quo. We know the best solutions are ones where we listen first to the American people.

“There will be clipboards passed out in the audience for everyone to share with us your concerns and ideas. We will enter those into the official hearing record and take those back with us to Washington as we consider how to protect rural communities, our farmers and ranchers, and small businesses, and expand access to quality, timely health care.

“I want to thank everyone for taking time to come today, and particularly to our witnesses for sharing your stories.”