Big Bill and Huge Losses for Rural Health with Edwin Park, Shawn Martin and Nathan Baugh

Michelle kicks off this episode with Edwin Park, Research Professor at the Georgetown University Center for Children and Families, within the McCourt School of Public Policy. His work primarily focuses on Medicaid, the Children’s Health Insurance Program, and the Affordable Care Act. Previously, he worked for 17 years at the Center on Budget and Policy Priorities, most recently as Vice President for Health Policy. He was also a health policy advisor for the White House National Economic Council, a Medicaid professional staff member for the U.S. Senate Finance Committee, and a health law attorney in private practice. In addition, Edwin served on the Biden-Harris Presidential Transition team. He is also a member of the National Academy of Social Insurance.

During this conversation, Michelle and Edwin discuss the implications of H.R.1, also known as the One Big Beautiful Bill Act, focusing on the significant cuts to Medicaid and their impact on rural health systems. They examine the financial strain on rural hospitals, the challenges faced by states implementing Medicaid expansion, and the broader implications for communities across the political spectrum. The discussion highlights the importance of advocacy and accountability in response to these changes.

In part two of this episode, Michelle meets with Shawn Martin, Executive Vice President and Chief Executive Officer of the American Academy of Family Physicians (AAFP), and Nathan Baugh, Executive Director of the National Association of Rural Health Clinics (NARHC). Shawn provides strategic leadership to the AAFP and directs the mission-driven work of the nation’s largest primary care organization. A strategic leader with a proven track record of accomplishments, Shawn is nationally recognized for his thoughtful leadership on a range of health care policy and workforce issues. While his career portfolio includes focused work on numerous healthcare and public policy issues, he is best known for his extensive work and national leadership on the development and implementation of primary care delivery and payment models, as well as workforce issues.

Before becoming the Executive Director of NARHC in July 2022, Nathan served as the Director of Government Affairs. In this role, he was instrumental in the passage of the Rural Health Clinic Medicare payment reforms, which were signed into law as part of the Consolidated Appropriations Act of 2021. This legislation was the most significant overhaul to the rural health clinic program in the last twenty-five years. As Executive Director, Nathan provides strategic direction for NARHC and remains involved in RHC advocacy priorities, including telehealth and Medicare Advantage.

With all eyes focused on legislation that will have sweeping implications for rural health clinics and physicians, Shawn, Nathan, and Michelle discuss the impact of stagnant payment rates and administrative burdens, differences between rural health clinics and FQHCs, the effects of Medicaid cuts, barriers to healthcare, challenges in recruiting and retaining healthcare professionals in rural areas, the importance of advocacy at the state level to mitigate the negative impacts of recent legislation, and strategies for healthcare professionals to engage in policy discussions and advocate for change.