Rural Issues

Of Texas' 254 counties, 70 percent are considered rural. Yet, only 160 of the state's 600 hospitals are rural. Rural Texas hospitals have unique needs and challenges. Although about 17 percent of Texas residents are without health insurance, the rate of uninsured is up to 20 to 25 percent in some rural counties. Compared with their urban counterparts, they serve a larger proportion of older and uninsured and publicly insured patients.

More than 20 rural hospitals have closed since 2013--more than any other state, and a number of other rural hospitals have eliminated key services lines. Today, only 66 of Texas' 160 rural hospitals provide labor and delivery services. 

Protecting rural hospitals and their ability to provide access to quality care is critical now more than ever. 

Protecting quality health care in rural communities means:

1. Bolstering Medicare and Medicaid reimbursement, (including Medicare reimbursement for critical access hospitals at 101 percent of costs), maintaining hospital supplemental payments and reducing the number of uninsured Texans. 

2. Protecting special financing arrangements that address some of rural hospitals' unique circumstances and challenges. 

At the federal level, protecting the Medicare program is particularly important.Medicare reimbursement for critical access hospitals 


Jennifer Banda, senior vice president, advocacy and public policy, 512/465-1046

Rural Hospital Financing
Rural Hospital Financing