WASHINGTON — Arizona lawmakers are calling on Congress to prioritize rural Americans in the next round of coronavirus legislation.
The pandemic has widened America’s “urban-rural divide,” according to Rep. Tom O’Halleran, a Democrat who represents the sprawling 1st District in the eastern half of the state. If Congress doesn’t take drastic steps to support rural Americans, it will “once again leave rural Arizona, and rural America, behind,” he wrote in a recent letter to House Speaker Nancy Pelosi (D-Calif.).
Democratic Rep. Ruben Gallego agreed.
“There still has to be a lot more done in order to help rural America,” he told Arizona Mirror Tuesday.
Media coverage of the pandemic has focused on urban hotspots like New York City, New Orleans and Seattle. But the virus is increasingly affecting rural America — and the resources aren’t in place to address it, O’Halleran told the Mirror.
Eighty-six percent of rural counties have had at least one case of COVID-19, according to Carrie Henning-Smith, a public health professor at the University of Minnesota. And the number of cases and deaths are growing at faster rates in rural areas than in metropolitan areas, according to a report released last week by the Kaiser Family Foundation.
The Navajo Nation has one of the highest infection rates per capita in the country.
Rural Americans — who comprise 15 to 20% of the U.S. population — face greater health risks than their urban and suburban counterparts. They tend to be older, have higher rates of underlying health conditions and are more likely to have low incomes, live in poverty and be unemployed and uninsured, Henning-Smith said.
The statistics are worse for minority groups in rural America, said Maggie Elehwany, vice president of government affairs and policy at the National Rural Health Association.
Rural Americans also have less access to health care providers, and many rural health facilities are struggling financially, she said.
The situation has been made worse by the COVID-19 pandemic, according to Dan Dirksen, director of the University of Arizona Center for Rural Health. Individuals have been reluctant to access care because they fear exposure to the virus, and uncompensated or “charity” care has increased as people have lost their jobs – and the health insurance that goes along with it, he said. At the same time, hospitals and clinics have faced bans on elective surgeries, a main source of income.
The economic consequences of the pandemic are “just as rough, if not rougher” for rural Americans than for their urban and suburban counterparts, O’Halleran said, noting that rural Americans still haven’t fully bounced back from the Great Recession of 2008.
Rural Americans are eligible for many benefits Congress has approved so far in its nearly $3 trillion in relief packages, such as direct payments to individuals and loans for small businesses. And Congress has taken some steps that have especially benefited rural America, such as temporary waivers on restrictions to telehealth and support for tribal communities.
Last week, the U.S. Department of Health and Human Services announced it would begin distributing $10 billion approved for rural hospitals. Of that, 84 hospitals, clinics and health centers in Arizona will receive nearly $83 million.
‘We can’t allow mass layoffs’
But O’Halleran says much more help is needed.
At the top of his list: aid for local governments, which are facing revenue losses in the wake of the pandemic. As a result, funding for police, fire departments, emergency responders, schools, trash collectors, libraries and other civic spaces is under threat.
Democratic Rep. Greg Stanton, a former mayor of Phoenix, agreed, telling reporters Wednesday that “we can’t allow there to be mass layoffs in the public sector moving forward,” especially as fire departments brace for a bad fire season this summer.
But aid for state, local and tribal governments has become a flashpoint on Capitol Hill.
Lawmakers from both parties have expressed support for the issue, but some prominent Republicans have bristled at the idea. Senate Majority Leader Mitch McConnell (R-Ky.) said last month he was open to allowing states to file for bankruptcy, but has since softened his position.
“Partisan politics in Washington shouldn’t put responsible states like Arizona — or our cities, towns, or counties that operate on shoestring budgets — at risk of bankruptcy,” Sen. Kyrsten Sinema (D) said in a statement. “We have bipartisan support in the Senate for revenue-replacement to keep our states, counties, and cities strong and thriving.”
In March, Congress set aside $150 billion in its $2.2 trillion COVID-19 aid package to help cities and states respond to the pandemic. But the legislation only provides direct aid to municipalities with more than 500,000 people.
Only two of Arizona’s 15 counties received direct federal assistance, according to O’Halleran.
In April, a pair of bipartisan senators unveiled a proposal to provide states and municipalities with $500 billion in stabilization funds. But the proposal would not apply to cities, towns and unincorporated communities with fewer than 50,000 people, of which there are hundreds in Arizona.
Such population thresholds highlight inequities facing small-town America, Henning-Smith said.
O’Halleran Stanton, Gallego and three other Arizona lawmakers — Reps. Raúl Grijalva (D), Ann Kirkpatrick (D) and Paul Gosar (R) — back legislation that would provide $250 billion in aid for cities and towns with fewer than 500,000 people.
The state’s other Republicans — Reps. Debbie Lesko, David Schweikert and Andy Biggs — have not signed on to the bill and did not respond to requests for comment.
O’Halleran wants the U.S. Department of Agriculture to create a rural COVID-19 task force, and he has also called for more federal support for rural America in areas like health care, funding for small businesses and tribal communities, and expanded access to high-speed internet.
Other Arizona lawmakers also want Congress to do more to expand telehealth, bridge the “digital divide,” and support rural hospitals and health providers in rural areas. Sinema has also called for direct relief funding for smaller Arizona cities and towns.