Improving Care in Rural America Reauthorization Act of 2025
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Would reauthorize three Health Resources and Services Administration (HRSA) rural health grant programs through fiscal year 2030, while adding new requirements that grant funds be directed toward meeting the health care needs of underserved rural populations and involving them in project planning and implementation.
What this bill would do
What it would do
The bill would extend the authorization for three HRSA grant programs supporting rural health care — Rural Health Care Services Outreach grants, Rural Health Network Development grants, and Small Health Care Provider Quality Improvement grants — from the current window of FY2021–2025 through FY2026–2030. It would do this by amending Section 330A of the Public Health Service Act. Alongside the reauthorization, the bill would add new conditions for two of those programs: grants for expanding outreach services and grants for developing integrated health care networks would both be required to direct funds toward underserved rural populations and to involve those populations in project development and ongoing operations.
The bill does not specify appropriation dollar amounts; it reauthorizes the existing statutory authority that allows HRSA to make grants. Actual funding levels would still depend on annual appropriations.
Key provisions
- 1Would reauthorize three HRSA rural health grant programs by extending their authorization period from FY2021–2025 to FY2026–2030.
- 2Would require HRSA to ensure Rural Health Care Services Outreach grant funds meet the health care needs of underserved rural populations and involve them in project development and operations.
- 3Would require HRSA to ensure Rural Health Network Development grant funds increase access to care for underserved rural populations and involve them in planning, development, and ongoing network implementation.
Who would be affected
Rural health care providers — including hospitals, clinics, and collaborative health networks — that apply for HRSA rural health grants. State and local health organizations working in rural areas, particularly those serving underserved populations such as low-income residents and communities with limited access to care, would be the primary beneficiaries of the reauthorized grant programs.
Why it matters
Without reauthorization, the statutory authority underpinning these three grant programs would expire after FY2025, potentially cutting off a funding pathway for rural health providers. The new underserved-population requirements create an explicit obligation for HRSA to steer grant dollars toward the rural residents least likely to otherwise access quality care and to give those communities a voice in how programs are designed.
What would change
Changes to existing law
Amends Public Health Service Act, Section 330A (42 U.S.C. 254c) (Sec. 2)
Extends the authorization for rural health grant programs from FY2021–2025 to FY2026–2030 and adds underserved-population use-of-funds requirements for outreach and network development grants.
Agencies directed to act
Effective dates
- Reauthorization period for the three rural health grant programs
Funding and costs
Congressional Budget Office estimate
CBO estimates H.R. 2493 would cost $330 million over the 2026–2030 period and $60 million after 2030, with no effect on direct spending, revenues, or the deficit.
H.R. 2493 would reauthorize $80 million per year from 2026 through 2030 for the Health Resources and Services Administration (HRSA) to expand rural health care delivery, support integrated rural health networks, and improve small rural health care providers. Because the funding is discretionary (subject to annual congressional appropriations rather than automatic spending), CBO estimates outlays of $330 million over the 2026–2030 period and an additional $60 million after 2030, based on HRSA's historical spending patterns. The bill has no effect on direct (mandatory) spending or revenues, and therefore does not affect the deficit. CBO identified no intergovernmental or private-sector mandates in the bill.
How implementation would work
HRSA's Director would continue awarding competitive grants under the three programs. For outreach and network development grants, the Director would be required, when making award decisions, to ensure that grantees commit to using funds for underserved rural populations and to involving those populations in project planning and operations. No new rulemaking timeline is specified; the new population-focus requirements would apply in future grant cycles under the reauthorized authority through FY2030.
Legislative status & sources
Latest action
Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 377.
Official CRS summary
Show the CRS summaryHide the CRS summary
This bill reauthorizes through FY2030 grant programs administered by the Health Resources and Services Administration (HRSA) that provide funding to health care service providers and related entities in rural areas.
Specifically, the bill reauthorizes grants for
- expanding the delivery of health care services in rural areas,
- developing integrated health care networks (i.e., collaborative groups of local health care organizations) in rural areas, and
- improving the quality of services provided by small health care providers in rural areas.
Also, the bill requires HRSA to ensure that grant funds for expanding services or developing health care networks are used to (1) meet the health care needs of underserved populations, and (2) engage such populations in the planning and implementation of related activities.
Legislative subjects
Health; Health care coverage and access; Health programs administration and funding; Rural conditions and development
Committee report
H. Rept. 119-325