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Causer Shares the Blame For Our Rural Healthcare Crisis.
Causer Shares the Blame For Our Rural Healthcare Crisis.
Restrictive "Scope of Practice" Laws: State politicians write the laws that dictate exactly what Nurse Practitioners (NPs), Physician Assistants (PAs), Pharmacists, and Dental Hygienists are legally allowed to do. In many states, heavy lobbying by physician groups (1) has led lawmakers to restrict these professionals from practicing independently. In rural areas where doctors are scarce, preventing NPs and PAs from stepping up and providing primary care directly chokes off access to healthcare. (Pennsylvania's own Rural Health Transformation Plan explicitly docks the state points for having restrictive scope of practice laws for PAs, NPs, and Pharmacists) .
Restrictive "Scope of Practice" Laws: State politicians write the laws that dictate exactly what Nurse Practitioners (NPs), Physician Assistants (PAs), Pharmacists, and Dental Hygienists are legally allowed to do. In many states, heavy lobbying by physician groups (1) has led lawmakers to restrict these professionals from practicing independently. In rural areas where doctors are scarce, preventing NPs and PAs from stepping up and providing primary care directly chokes off access to healthcare. (Pennsylvania's own Rural Health Transformation Plan explicitly docks the state points for having restrictive scope of practice laws for PAs, NPs, and Pharmacists) .
Medicaid Reimbursement and Expansion Decisions: State governments manage their own Medicaid programs. Politicians who have chosen to keep Medicaid reimbursement rates artificially low have directly starved rural clinics and hospitals of operating cash. Furthermore, in states where politicians blocked the Affordable Care Act's Medicaid expansion, rural hospital closure rates skyrocketed because those hospitals were forced to absorb the costs of uninsured patients showing up in their emergency rooms (2).
Medicaid Reimbursement and Expansion Decisions: State governments manage their own Medicaid programs. Politicians who have chosen to keep Medicaid reimbursement rates artificially low have directly starved rural clinics and hospitals of operating cash. Furthermore, in states where politicians blocked the Affordable Care Act's Medicaid expansion, rural hospital closure rates skyrocketed because those hospitals were forced to absorb the costs of uninsured patients showing up in their emergency rooms (2).
Underfunding Foundational Infrastructure: For decades, state legislatures have treated Emergency Medical Services (EMS) as local "ambulance services" rather than essential, state-funded healthcare infrastructure (4). Failing to provide structural state funding for EMS, broadband internet (necessary for telehealth), and non-emergency medical transportation has left rural healthcare systems fragile and disconnected.
Underfunding Foundational Infrastructure: For decades, state legislatures have treated Emergency Medical Services (EMS) as local "ambulance services" rather than essential, state-funded healthcare infrastructure (4). Failing to provide structural state funding for EMS, broadband internet (necessary for telehealth), and non-emergency medical transportation has left rural healthcare systems fragile and disconnected.
Slow Adoption of Interstate Compacts: Telehealth could have relieved rural workforce shortages years ago, but many state politicians have been slow to join interstate medical licensure compacts. By requiring doctors to jump through bureaucratic hoops to get licensed in multiple states, lawmakers have made it legally and financially difficult for out-of-state specialists to treat rural patients virtually (4).
Slow Adoption of Interstate Compacts: Telehealth could have relieved rural workforce shortages years ago, but many state politicians have been slow to join interstate medical licensure compacts. By requiring doctors to jump through bureaucratic hoops to get licensed in multiple states, lawmakers have made it legally and financially difficult for out-of-state specialists to treat rural patients virtually (4).
2nd largest (tied) donor to Martin Causer in 2024 was Upper Allegheny Health Systems: https://www.opensecrets.org/officeholders/martin-t-causer/contributors?cycle=2024&id=13005723&recs=100
Causer voted down this expansion: https://www.palegis.us/house/roll-calls/summary?sessYr=2025&sessInd=0&rcNum=782
To his credit Causer introduced a bill (this legislative session) to address this need. However, he has been in office for 24 years.
2024 (HB1512) The most comprehensive bill to pass the state legislature on telehealth. It was introduced and co-sponsored only by Democrats.
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