Welcome to the Virtual Event we are having. This is concerning confronting the healthcare crisis in Rural America. Today we are releasing recommendations for this. Im bill hoagland, a Senior Vice President with the center, and have the distinct pleasure of working with and overseeing our health care project. We have a very full agenda. Let me get a few logistics out of the way quickly. We are all adjusting to this new way of conducting meetings and events. We hope everything works out as we go through and i want to say thank you to the Production Company for helping us put this on. For those of you who have joined this zoom platform, you will receive a message shortly from one of our staff, morgan bailey, in the chat box function with a link to the report. For the viewers, the cspan viewers and others who wish to get a copy of the report, you can go to our website, bipartisan policy. Org, and a link will be on the bpc events page under the health section. Later this morning, you will have an opportunity to submit your questions to our Task Force Members via the q and a function at the bottom of your screen. Event purpose of this personally coming from a rural , area of indiana with our family farm still operational, this is a personal issue with me. Over 126 hospitals have closed since 2010. An estimate of nearly 560 hospitals were at risk of closing, even before covid19 outbreak. Dr. Susan turney is the chief executive of the Marshfield ClinicHealth System in wisconsin, a system that we work with at bpc. She was recently quoted, the Rural Health Care was in a crisis before this pandemic, and that funding to stabilize systems today is critical so we can continue to survive. We are hopeful an agreement can be reached in congress, even in the senate, and maybe later today to add additional funding to our Hospital Systems that are so in dire need of assistance. And particularly those in rural areas. At the outset, we would like to thank the Helmsley Charitable trust for its work we have done with the rural task force. We launched this project over a year ago long before covid19 was an issue. We believe many of the recommendations today can help stabilize rural hospitals during this Current Crisis and better support the Rural Health Care system post crisis. Our task force was cochaired by olivia snow, who will will hear from. Along with two other cochairs, former governor Ronnie Musgrove of mississippi, and Tommy Thompson of wisconsin. The bp staff and Task Force Members visited rural hospitals in New Hampshire and iowa, maine, tennessee, vermont, even wisconsin. We also have the insights of an honorary Bipartisan Congressional Task force on Rural Health Care, including senators Chuck Grassley of iowa, cana smith of minnesota, bill cassidy of louisiana, angus king of maine, congressman Jodey Arrington of texas, and congresswoman taurus small of new mexico. Senator grassley has not been able to join us this morning, but has given me a statement to read. That will be followed by a video from congresswoman small, and one from senator cassidy. Before i turn it over to the director of the Health Project for discussion with members of the task force, senator grassleys statement. As a solutionsoriented organization, the Bipartisan Policy Center has the leadership bench from which to help shape the Rural Health Care debate. I welcome and encourage the bpc advocacy efforts that bring a range of policy options to the table. As chairman of the Senate Finance committee, i have in working over the past year to develop a targeted set of common sense policies that help isolate Rural Communities provide reasonable access and needed medical care as close to home as possible. I will continue leveraging my leadership positions to champion innovative, costeffective, and highquality Rural Health Care policy solutions. I will review the policy options released today carefully. It is my hope that these recommendations will spur more candid dialogue among the unique challenges facing our Rural Health Care delivery system. This is important as lawmakers develop Meaningful Solutions and Work Together to have a bipartisan path forward. Cross Party Coalitions are the best way to turn targeted Rural Health Care solutions into law. I ask them to work with me to help build that kind of Bipartisan Coalition as i work on formulating policies that will get more lawmakers on board in washington. The bottom line is, Rural Health Care matters. Many Rural Communities are struggling to Keep Health CareServices Available to their residents. This is especially true with the pressures of the ongoing nationwide fight against covid19. The sacrifices and efforts to stop the virus have shut down that u. S. Economy and life as we know it this virus has and will continue to invade small towns and big cities. One thing we can count on is our rural hospitals and providers are standing guard on the front lines ready to care for the People Living in their own communities. Even as the devastating effects of the Public Health emergency deal a blow to the economy and exhaust health care professionals, we can see communities banding together to help neighbors in need in ways big and small. Americas entrepreneurs, medical scholars, innovators, data scientists, and captains of industry are collaborating through our civic organizations, economic institutions, and all levels of government to stop the spread, save lives, and solve problems. We need to harness that same energy to make sure rural providers are equipped to address the unique needs of their communities now and in the future. Pitching in and pulling together the resilience of the american spirit will guide us to better days ahead. Thank you. At this time, we will have a smallfrom congresswoman from new mexico. I apologize. I guess it is grassley. Thank you for joining the bipartisan policy for this first a Virtual Event. The Task Force Report and policy recommendation. Communities across the country are facing unprecedented time. We are having to fight to keep families safe and their lives together. All of america is hurting right now. Many Rural Communities are hurting. Since the start of this emergency i have fought for , emergency funding for Rural Health Care facilities, expanding telehealth in our rural areas, and protecting the Rural Health Care world. I have also joined my colleagues on both sides of the aisle and demand federal accountability to our Rural Community and calls for the administration to establish a rural covid19 task force. This Public Health crisis only heightens the need for bipartisan collaboration with a solutions that listen to our communities and take swift action. As we continue to fight the spread of covid19, partisan andtics must be set aside pass legislation for our Rural Community. Covid19 has also shown the importance of continuing this work even after the crisis. Challenges like access to food, reliable broadband, Health Care Must be addressed to ensure we are serving families no matter where they live. I introduced isolation to incentivize medical professionals and expand teleHealth Services. The fight for rural families will continue. The Task Force Recommendations are critical. Thank you for joining the bipartisan policy today. I look forward to working with many of you in the future. Obviously hoagland that was senator cassidy appearing instead of congresswoman torres. As i said we are all learning , this new technology. Hopefully we can work out some of these bugs. Now could we try to have senator cassidys video . Sen cassidy bill cassidy here, a doctor, but also a senator. In my medical practice i used to work in a hospital. That included many that had to come from our away from Rural Communities. Then i realized these folks have transportation. A lot of folks in Rural Communities relying on others which is to say they may or may not have transportation. I am aware of the challenges, but how do we improve access and care to those in Rural Communities . This has been highlighted by the Novel Coronavirus epidemic. Although right now, the Rural Communities have been relatively unscathed, i saw an article in the New York Times in which we begin to see increasing numbers of cases in the Rural Communities. Our challenge is how to preserve increased access, improve care in Rural Communities, and the future is now. The cost of health care is too high. Insurance deductibles on these change plans are extremely high. The cost of medications are very high. If you look at diabetes in the rural areas, more of them are going to be diabetics, so the cost of insulin will be a particular problem. Its also difficult to recruit providers to rural areas. It is kind of a vicious cycle, in that the economic fortune of a community declines, and there is appeal to a spouse. They have another career where they work if there is an economic decline, which means your workforce gets older and the kids grow up and move away. Then again, you have more economic decline, because you dont have a young doctor to attract a family with the assurance of good health care. You need to reverse that somehow. Statistically, those in rural areas are older, not just the workforce, but everybody. A little bit older and more chronic disease. So again we have a challenge how , to preserve access to health care in rural areas, improve it to raise it up. What are we attempting to do . The Novel Coronavirus epidemic is going to give us a lot of tragedy. It has disrupted our economy. There might be good things that come out of it. For example, we are expanding the use of telehealth. That is wise. Now a provider can communicate with the person across town, across the state, and deliver services. We had that capability before in rural areas. Because of the need to implement this because of the virus they , are going to scale. Going to scale would be beneficial. Secondly, we are making more use of home health. Before, a patient would go to the doctor, the doctor would evaluate them, fill out a form and they would go home with. Expanded use of telehealth, it may be physically seeing the patients, but they can monitor Blood Pressure with a Blood Pressure cuff or a oxygen oximeter, and those at home 100 miles away from the doctor that have to see if there is an issue consent home health to the home and have the condition addressed and the patient never needs to come in. If a patient in a rural area for transportation, maybe they did not have transportation, we kind of eliminate that as an issue of expanded use of remote monitoring, telehealth as well as home health. I will also point out under this , current law, we are allowing standard use of telehealth. It doesnt have to be something with a videoconference. It can be a smart phone in which somebody speaks to the doctor this way, and it is communicated on the smartphone. That may or may not stay in place after the coronavirus, but i think we are becoming more innovative on how to use current technology. Theres is a special need as well for maternal health. If you look at those outcomes they cannot be as good for those children ifvering they come from rural areas as they are in suburban or urban areas. We have to address that as a special case. Theres a lot of effort to do that. Im sponsoring some of that in federal legislation. So we continue, if you will, by a variety of circumstances to attempt to preserve our health care in the rural area and improve. , one thingan we do we do is draw the attention of leaders and policymakers and those who we also have to explore this and understand in a way which unless you have been there, you may not understand. We have to understand someone who lives 50 miles away from the doctor who has a call that is 40 who has a car that is 40 years old may not be able to get to the doctor. That fundamental lack of understanding, the circumstances of a poor persons life who lives in a rural area, that limits the imagination of what we are attempting to do. We have to come up with novel financing plans. Theres been a lot of attempts. For example, through the Affordable Care act and other organizations to reduce the costs. But if those folks are in the rural area they should be , sharing with the rural hospitals. You need to preserve the rural hospital so the patient has a place to go if there is an emergency. A place to go to get labs done. It also provides employment for the economy. By the way, did i say she doesnt have good access . This brings the care closer to her. The mission of the rural hospital will evolve, but there still needs to be sharing through financial policies. This would allow them to keep the doors open. I think there has to be novel ways of delivering health care. My practice involved Public Health. We vaccinated 6000 children are hepatitis b and we did it by bringing vaccinations to the classroom at no cost to the parents and teachers. We vaccinated the children at school. We brought the health care to the student. We need to think of other ways to bring the health care, for example a mobile mammography unit so that the person does not have to drive 50 miles to get a mammogram. She can have it through a mobile unit. I think you have the concept. I thank you. Our mutual goal is how to improve access and improve health care in the rural areas. It is important for the patients and important for the economics in the rural area. Thing, if theres one thing the coronavirus taught us, we are in it together. I would also add it acknowledges we are in it together. Thank you. Vice pres. Hoagland i would like to introduce the task force panel. So, marilyn, it is up to you. Good morning, everyone. Thank you for joining us. I would like to introduce our panel who is going to help us understand what in the report. We will go over the highlights of the report. They are members of our task force. We have two of our cochairs with us majority leader tom daschle. ,he is also a cofounder of the bpc. We have former senator olivia snow of maine, who is also a cochair of the task force. Shes also a senior fellow and board member at the bpc. A former congressman from iowa with us and also chris jennings, founder and president of jennings policy strategies. You will also remember he was in the clinton and obama white houses working on health care and he is a senior fellow at bpc. We also have gail belinsky, senior fellow at project health. She is also a former administrator of the Health Care Financing administration, which we now know as the centers for medicare and medicaid services. Id like to repeat a couple of the housekeeping points. First, if you have a question at any time during this event, you may go ahead and ask. You will click on the q and a feature and submit your question. I will go ahead and ask the panelists as many questions as we have time for. You will also notice there is a chat function in zoom. If you click on chat, you will not be speaking with one another, but what you can use chat for is to receive information from us at the bpc. For example, our staff has posted the link to our report. If you would like to see that link, go ahead and open chat. You will see the url for that and see the report. The other thing i wanted to tell you is you have either gotten into zoom, but the other way to watch this webinar is through youtube. The way to do that is to go to the website, bipartisanpolicy. Org. Click on events, and you will see a link to watch this. At this time, i will turn it over to our Task Force Members who will go through the highlights of our report. We will start with senator daschle. Daschle thank you very much. Today, we have announced the release of our recommendations on the Rural Health Task force. For the last year, my colleagues and i have worked to find Common Ground to stabilize and improve the challenges facing Rural Communities. Even before the stress of covid19, these problems were urgent. As a senator, representing south dakota, i have long understood that the population