Heated hearing on bill to remove 15‑mile limit around critical‑access hospitals exposes deep split on rural care

The Senate Health and Human Services committee heard extended testimony on House Bill 223, a proposal by Rep. John McClain to repeal the 15‑mile notice and review provision that applies to proposed health facilities located near federally designated critical access hospitals (CAHs).

Rep. McClain opened the hearing by describing a long‑running decline in rural access: hospital bankruptcies, suspended services and a steady loss of birthing units across the state. "Part of the problem is that we have fallen back into a position where we're now relying on the state's critical access hospitals as the almost exclusive provider of non‑primary care in the rural areas," he said, adding that the 15‑mile rule effectively bars most parts of the state from new ambulatory care development.

Supporters of the repeal urged the committee to allow private providers to try new models in rural markets. Nick Veil, CEO of Bedford Ambulatory Surgical Center and former state health commissioner, said the existing regime protects "franchises" and raises costs, leaving rural residents to pay higher prices: "The people who can least afford it...are paying…