Big bill's rural-health items touch Medicaid money, telehealth rules, mental-health hotline, drug treatment, Native care

Senate Majority Leader Chuck Schumer speaks with reporters as he
walks to a vote at the U.S. Capitol. (Photo by Francis Chung, Politico)

The whopping 4,155-page omnibus spending bill is whipping its way through Congress. The $1.7 trillion measure is crammed with public-policy changes and funding provisions.

Here are some items with rural resonance that made it in, starting with several health-related provisions:

• An earlier end to Covid-era state Medicaid funding and rules. Additional funding will end on April 1, 2023, instead of June 30. The change will end rules that effectively barred any state from dropping people from the rolls if the state wanted to get the 6.2% bonus.
  
• An extension of rules that supported telehealth options through 2024, which "falls far short of a push from some lawmakers who wanted to make that flexibility permanent," Politico notes. The pandemic ushered in telehealth as accepted medical care.
• Almost $502 million, a nearly $400 million increase, for the new 988 national hotline for mental-health services. "The ultimate goal is to be able to dispatch mobile crisis teams immediately to anyone in need, no matter where they live," The Washington Post reports.
• Easier access for health-care providers to prescribe buprenorphine to treat opioid addiction. They would no longer have to get a separate waiver from the Drug Enforcement Administration.
• More stable funding for the Indian Health Service, a result of perhaps the largest effort by Native American groups "to provide more funding certainty to the federal health agency that helps serve roughly 2.6 million American Indians and Alaska Natives," the Post reports.
• A limit for tax breaks on land-conservation purchases: "The provision would automatically disallow any deduction that is 2.5 times more than what investors put into a partnership that is making the deals — an indication that easement organizers artificially inflated the value of conserved land to get more tax savings," reports Benjamin Guggenheim of PoliticoPro.
• "Maine lawmakers successfully included a pause on new regulations they warned would cripple their state’s lobster industry," Politico reports. "The provision delays new rules by six years, which critics argue will allow fisheries to put off actions that would prevent fishing gear from harming and even killing endangered whales."
  
• UPDATE: The bill funds a program that gives poor families $40 per month per child for summer groceries, and "allows schools and nonprofits in rural areas to deliver meals or offer pick-up options to families during those months," The New York Times reports.

The bill would also amend the Electoral Count Act of 1887 to make clear that the vice president, as presiding officer of the Senate, plays only a ministerial or ceremonial role in the counting of electoral votes from the states. The law's vagueness contributed to the violence at the Capitol on Jan. 6, 2021. The bill would also raise the threshold for challenging electoral votes to one-fifth of both the House and Senate, from the current one member of each chamber.