Rural Obstetrics Readiness Act
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Rep. Kelly, Robin L. [D-IL-2]
ID: K000385
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Bill Summary
Another "feel-good" bill from the geniuses in Congress, designed to make it seem like they care about rural healthcare while actually just throwing money at a problem and hoping it goes away.
**Main Purpose & Objectives:** The Rural Obstetrics Readiness Act (HR 1254) claims to aim at improving obstetric emergency care in rural areas. Yeah, right. Its real purpose is to provide a nice photo op for the sponsors while funneling more taxpayer money into the healthcare-industrial complex.
**Key Provisions & Changes to Existing Law:** The bill amends existing law to create new grant programs and funding streams for rural health care facilities. Specifically:
* It establishes an obstetric emergency training program, because apparently, rural healthcare providers need special training to deal with basic emergencies. * It authorizes $5 million in grants for fiscal years 2026-2028, which will likely be squandered on bureaucratic overhead and "consulting fees" rather than actual medical care. * It creates a new grant program (Section 330A-3) to support obstetric services in rural areas, with an authorized appropriation of $15 million for fiscal years 2026-2029. Because what's a few more million dollars when you're already hemorrhaging money? * It establishes a pilot program for teleconsultation services, because nothing says "quality healthcare" like a video conference with a doctor who's probably not even in the same state.
**Affected Parties & Stakeholders:** The usual suspects:
* Rural health care facilities and hospitals, which will receive the bulk of the funding (and likely waste most of it on administrative costs). * Healthcare providers, who will get to attend more "training sessions" and collect a paycheck for doing so. * Lobbyists and special interest groups, who will make a killing off the new grant programs and funding streams. * Taxpayers, who will foot the bill for this boondoggle.
**Potential Impact & Implications:** The impact of this bill will be negligible at best. It's just another example of Congress throwing money at a problem without addressing the underlying issues. The implications are clear:
* More bureaucratic red tape and administrative costs. * Wasted taxpayer dollars on "training programs" and "consulting fees." * A continued lack of actual, meaningful healthcare reform. * And, of course, more opportunities for politicians to grandstand and pretend they care about rural healthcare.
In short, this bill is a joke. It's a Band-Aid on a bullet wound, designed to make Congress look like it's doing something while actually accomplishing nothing.
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đź’° Campaign Finance Network
Rep. Kelly, Robin L. [D-IL-2]
Congress 119 • 2024 Election Cycle
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Project 2025 Policy Matches
This bill shows semantic similarity to the following sections of the Project 2025 policy document. Higher similarity scores indicate stronger thematic connections.
Introduction
— 467 — Department of Health and Human Services l Direct dollars to beneficiaries more effectively and responsibly. The current funding structure for the Medicaid program rewards expansions, lacks transparency, and promotes financing gimmicks. CMS should: 1. End state financing loopholes. 2. Reform payments to hospitals for uncompensated care. 3. Replace the enhanced match rate with a fairer and more rational match rate. 4. Restructure basic financing and put the program on a more fiscally predictable budget (which should include reform of Disproportionate Share Hospital payments to hospitals).31 l Strengthen program integrity. Make program integrity a top priority and the responsibility of the states. To protect the taxpayers’ investment: 1. Incentivize states. An enhanced contingency fee should be paid to states that successfully increase their efforts to decrease waste, fraud, and abuse. The current system’s IT development 90/10 matching rate should be allowed for improvements in states’ current fraud and abuse and eligibility systems. Innovative programs that show a positive return on investment for both the state and federal governments should be allowed without the onerous waiver process. 2. Improve Medicaid eligibility standards to protect those in need. As Medicaid enrollment continues to climb, it is imperative that there are appropriate and accurate eligibility standards to ensure that the program remains focused on serving those who are in need. To this end, CMS should: a. Hold states accountable for improper eligibility determinations. b. Require more robust eligibility determinations. c. Strengthen asset test determinations within Medicaid.32 3. Conduct oversight and reform of managed care.33 l Incentivize personal responsibility. CMS should allow states to ensure that Medicaid recipients have a stake in their personal health care and a say in decisions related to the Medicaid program. Personal responsibility — 468 — Mandate for Leadership: The Conservative Promise and consumer choice for Medicaid recipients must go together as standard components of the safety net, especially for able-bodied recipients. Medicaid recipients, like the rest of Americans, should be given both the freedom to choose their health plans and the responsibility to contribute to their health care costs at a level that is appropriate to protect the taxpayer. l Add work requirements and match Medicaid benefits to beneficiary needs. Because Medicaid serves a broad and diverse group of individuals, it should be flexible enough to accommodate different designs for different groups. For example, CMS should launch a robust “personal option” to allow families to use Medicaid dollars to secure coverage outside of the Medicaid program. CMS should also: 1. Clarify that states have the ability to adopt work incentives for able- bodied individuals (similar to what is required in other welfare programs) and the ability to broaden the application of targeted premiums and cost sharing to higher-income enrollees. 2. Add targeted time limits or lifetime caps on benefits to disincentivize permanent dependence.34 l Allow private health insurance. Congress should allow states the option of contributing to a private insurance benefit for all members of the family in a flexible account that rewards healthy behaviors. This reform should also allow catastrophic coverage combined with an account similar to a health savings account (HSA) for the direct purchase of health care and payment of cost sharing for most of the population. l Increase flexible benefit redesign without waivers. CMS should add flexibility to eliminate obsolete mandatory and optional benefit requirements and, for able-bodied recipients, eliminate benefit mandates that exceed those in the private market. This should include flexibility to redesign eligibility, financing, and service delivery of long-term care to serve the most vulnerable and truly needy and eliminate middle-income to upper- income Medicaid recipients. l Eliminate current waiver and state plan processes. CMS should allow providers to make payment reforms without cumbersome waivers or state plan amendment processes where possible. More broadly, the federal government’s role should be oversight on broad indicators like cost effectiveness and health measures like quality, health improvement, and
Introduction
— 467 — Department of Health and Human Services l Direct dollars to beneficiaries more effectively and responsibly. The current funding structure for the Medicaid program rewards expansions, lacks transparency, and promotes financing gimmicks. CMS should: 1. End state financing loopholes. 2. Reform payments to hospitals for uncompensated care. 3. Replace the enhanced match rate with a fairer and more rational match rate. 4. Restructure basic financing and put the program on a more fiscally predictable budget (which should include reform of Disproportionate Share Hospital payments to hospitals).31 l Strengthen program integrity. Make program integrity a top priority and the responsibility of the states. To protect the taxpayers’ investment: 1. Incentivize states. An enhanced contingency fee should be paid to states that successfully increase their efforts to decrease waste, fraud, and abuse. The current system’s IT development 90/10 matching rate should be allowed for improvements in states’ current fraud and abuse and eligibility systems. Innovative programs that show a positive return on investment for both the state and federal governments should be allowed without the onerous waiver process. 2. Improve Medicaid eligibility standards to protect those in need. As Medicaid enrollment continues to climb, it is imperative that there are appropriate and accurate eligibility standards to ensure that the program remains focused on serving those who are in need. To this end, CMS should: a. Hold states accountable for improper eligibility determinations. b. Require more robust eligibility determinations. c. Strengthen asset test determinations within Medicaid.32 3. Conduct oversight and reform of managed care.33 l Incentivize personal responsibility. CMS should allow states to ensure that Medicaid recipients have a stake in their personal health care and a say in decisions related to the Medicaid program. Personal responsibility
Introduction
— 154 — Mandate for Leadership: The Conservative Promise insurance at prices lower than the actuarially fair rate, thereby subsidizing flood insurance. Then, when flood costs exceed NFIP’s revenue, FEMA seeks taxpay- er-funded bailouts. Current NFIP debt is $20.5 billion, and in 2017, Congress canceled $16 billion in debt when FEMA reached its borrowing authority limit. These subsidies and bailouts only encourage more development in flood zones, increasing the potential losses to both NFIP and the taxpayer. The NFIP should be wound down and replaced with private insurance starting with the least risky areas currently identified by the program. Budget Issues FEMA manages all grants for DHS, and these grants have become pork for states, localities, and special-interest groups. Since 2002, DHS/FEMA have provided more than $56 billion in preparedness grants for state, local, tribal, and territorial governments. For FY 2023, President Biden requested more than $3.5 billion for federal assistance grants.13 Funds provided under these programs do not provide measurable gains for preparedness or resiliency. Rather, more than any objective needs, political interests appear to direct the flow of nondisaster funds. The principles of federalism should be upheld; these indicate that states better understand their unique needs and should bear the costs of their particularized programs. FEMA employees in Washington, D.C., should not determine how bil- lions of federal tax dollars should be awarded to train local law enforcement officers in Texas, harden cybersecurity infrastructure in Utah, or supplement migrant shelters in Arizona. DHS should not be in the business of handing out federal tax dollars: These grants should be terminated. Accomplishing this, however, will require action by Members of Congress who repeatedly vote to fund grants for political reasons. The transition should focus on building resilience and return on investment in line with real threats. Personnel FEMA currently has four Senate-confirmed positions. Only the Administrator should be confirmed by the Senate; other political leadership need not be con- firmed by the Senate. Additionally, FEMA’s “springing Cabinet position” should be eliminated, as this creates significant unnecessary challenges to the functioning of the whole of DHS at points in time when coordinated responses are most needed. CYBERSECURITY AND INFRASTRUCTURE SECURITY AGENCY (CISA) Needed Reforms CISA is supposed to have two key roles: (1) protection of the federal civilian government networks (.gov) while coordinating the execution of national cyber defense and sharing information with non-federal and private-sector partners — 155 — Department of Homeland Security and (2) national coordination of critical infrastructure security and resilience. Yet CISA has rapidly expanded its scope into lanes where it does not belong, the most recent and most glaring example being censorship of so-called misinformation and disinformation. CISA’s funding and resources should align narrowly with the foregoing two mission requirements. The component’s emergency communications and Chem- ical Facility Anti-Terrorism Standards (CFATS) roles should be moved to FEMA; its school security functions should be transferred to state homeland security offices; and CISA should refrain from duplicating cybersecurity functions done elsewhere at the Department of Defense, FBI, National Security Agency, and U.S. Secret Service. Of the utmost urgency is immediately ending CISA’s counter-mis/disinforma- tion efforts. The federal government cannot be the arbiter of truth. CISA began this work because of alleged Russian misinformation in the 2016 election, which in fact turned out to be a Clinton campaign “dirty trick.” The Intelligence Commu- nity, including the NSA or DOD, should counter foreign actors. At the time of this writing, release of the Twitter Files has demonstrated that CISA has devolved into an unconstitutional censoring and election engineering apparatus of the political Left. In any event, the entirety of the CISA Cybersecurity Advisory Committee should be dismissed on Day One. For election security, CISA should help states and localities assess whether they have good cyber hygiene in their hardware and software in preparation for an election—but nothing more. This is of value to smaller localities, particularly by flagging who is attacking their websites. CISA should not be significantly involved closer to an election. Nor should it participate in messaging or propaganda. U.S. COAST GUARD (USCG) Needed Reforms The U.S. Coast Guard fleet should be sized to the needs of great-power compe- tition, specifically focusing efforts and investment on protecting U.S. waters, all while seeking to find (where feasible) more economical ways to perform USCG missions. The scope of the Coast Guard’s mission needs to be focused on protecting U.S. resources and interests in its home waters, specifically its Exclusive Economic Zone (200 miles from shore). USCG’s budget should address the growing demand for it to address the increasing threat from the Chinese fishing fleet in home waters as well as narcotics and migrant flows in the Caribbean and Eastern Pacific. Doing this will require reversing years of shortfalls in shipbuilding, maintenance, and upgrades of shore facilities as well as seeking more cost-effective ship and facility designs. In wartime, the USCG supports the Navy, but it has limited capability and capacity to support wartime missions outside home waters.
Showing 3 of 5 policy matches
About These Correlations
Policy matches are calculated using semantic similarity between bill summaries and Project 2025 policy text. A score of 60% or higher indicates meaningful thematic overlap. This does not imply direct causation or intent, but highlights areas where legislation aligns with Project 2025 policy objectives.