WASHINGTON — U.S. Rep. Jill Tokuda took to the House floor on Wednesday to raise the alarm about rural health care and introduce the new Congressional Bipartisan Rural Health Caucus, which she relaunched last month and for which she now serves as co-chair.

What You Need To Know

  • The Congressional Bipartisan Rural Health Caucus was created to provide a forum for members of Congress to advocate for legislation and policy actions that improve access to quality, affordable health care and mental health services for people living in rural and remote communities across the country

  • U.S. Rep. Jill Tokuda, whose Second Congressional District includes suburban and rural parts of Oahu, the islands of Hawaii, Kauai, Maui, Lanai, Molokai, Niihau, Kahoolawe, and the Northwestern Hawaiian Islands, is co-leading the caucus with Rep. Diana Harshbarger (R-Tenn.)

  • Roughly 60 million Americans, about 20% of the total U.S. population, live in rural areas. Compared to their urban counterparts, these Americans are generally older, have fewer resources and are more likely to experience poor health care conditions

  • Tokuda said her goals for rural health care are centered on the four A’s of accessibility, affordability, acceptability and availability

“As the representative of one of the most rural and remote districts in the country, I have seen and heard firsthand the devastating consequences of inadequate access to care,” Tokuda told her House colleagues. “On every island in Hawaii, I have listened to difficult and painful stories of families who’ve lost loved ones simply because of where they live,” 

Tokuda, whose Second Congressional District includes suburban and rural parts of Oahu, the islands of Hawaii, Kauai, Maui, Lanai, Molokai, Niihau, Kahoolawe, and the Northwestern Hawaiian Islands, is co-leading the caucus with Rep. Diana Harshbarger (R-Tenn.). The caucus was created to provide a forum for members of Congress to advocate for legislation and policy actions that improve access to quality, affordable health care and mental health services for people living in rural and remote communities across the country.

In her speech on Wednesday, Tokuda cited the experiences of constituents who have faced the limitations of rural health care, including a Molokai woman whose daughter died away from her family because there wasn’t sufficient end-of-life care available on the island.

“In Waianae, a close friend and a community leader held up a (Centers for Disease Control) report in his hand and expressed his anger and his frustration that the life expectancy of residents living on the rural West side of Oahu was a decade less than those living in Downtown Honolulu,” she said. “In the small, close-knit community of Kauai, too many people have a family member or friend that took their own life. With limited access to mental health professionals, tools and services, our Garden Isle has historically struggled with high rates of suicide and suicide attempts. And in Kona, on the Big Island of Hawaii, a woman cried as she told me that her sister died because she couldn’t get the emergency care she needed in time.”

The first-term representative also cited her own personal experience of losing her mother in a car crash.

“She was in a car accident and the hospital in our community didn’t have the appropriate trauma services to deal with her injuries,” Tokuda said. “So, she was taken to the next town where she passed away shortly after getting to the ER.”

As Tokuda noted, roughly 60 million Americans, about 20% of the total U.S. population, live in rural areas. Compared to their urban counterparts, these Americans are generally older, have fewer resources and are more likely to experience poor health care conditions.

“While they require more medical attention and care, rural Americans often have more limited access to care as a result of physician shortages, lack of reliable transportation options, insufficient health insurance coverage and increased exposure to environmental and occupational hazards,” Tokuda said. “These disparities in health care access highlight the need for greater attention and resources aimed at improving health care and outcomes in rural and remote communities.”

Tokuda said her goals for rural health care are centered on the four A’s of accessibility, affordability, acceptability and availability.

“At a time of such deep divisions in our country and in Congress, we must find ways to come together to recognize the urgent needs of our constituents and do better for all of our people,” Tokuda said. “The Bipartisan Rural Health Caucus will look beyond the partisan gridlock of Washington to tackle the rural health care crisis in the United States. From the pristine sandy beaches of Hawaii to the Great Smoky Mountains of Tennessee, rural Americans are asking Congress to step up and take meaningful action to save their hospitals and clinics, address health inequities, strengthen their healthcare workforce pipeline, ensure fair and adequate reimbursement for providers and reduce health care costs for the health and wellbeing of all of our people.”

Michael Tsai covers local and state politics for Spectrum News Hawaii. He can be reached at michael.tsai@charter.com.