Rural Health Information Hub Latest News

Read About the Variations in Affordability of Health Care by Non-Metropolitan/Metropolitan and Race/Ethnicity Status across Eight Geographically Dispersed States

 Among the findings in this brief from the Rural & Minority Health Research Center: Hispanic adults had the lowest health insurance rates; non-Hispanic Black individuals reported higher levels of forgoing medical care due to cost; non-metropolitan individuals ages 18-64 were more likely to report forgoing medication due to cost.

Federal Awards Given Out to Support Education in High-Needs Communities.

  Last week, the U.S. Department of Education announced more than $35 million in grants awarded for projects that support “cradle-to-career” solutions for low-income students through the Department’s Promise Neighborhoods program.  The national nonprofit Partners for Rural Impact is one of the newest Promise Neighborhood grantees, supporting two schools in Hazard, Kentucky, where the U.S. Secretary of Education made the announcement.

Medicare Graduate Medical Education (GME) Residency Have Positions Available 

 Hospitals interested in residency slots that will be supported by Medicare in Fiscal Year 2024 must apply through the Medicare Electronic Application Request Information (MEARIS™) by March 31. This is the second of five rounds of awards; the first 200 slots were awarded earlier this month.  Rural hospitals are among the facility types eligible to establish new programs or expand existing residency programs. The Centers for Medicare & Medicaid Services will prioritize training sites located in Health Professional Shortage Areas (HPSAs), and Tribal facilities located outside of a HPSA. For more information, see the Frequently Asked Questions and the application submission process guideApplications are Due March 31.

Emergency Allotments to End in March for SNAP Households

From the Pennsylvania Department of Human Services (DHS)

Starting in March, recipients of Supplemental Nutrition Assistance Program (SNAP) benefits will no longer receive the Emergency Allotment (EA) additional payments created during the COVID-19 public health emergency and will resume receiving one SNAP payment per month.

These additional SNAP payments have been crucial for people over the past three years during the COVID-19 pandemic. Ongoing economic uncertainty and high food prices are contributing to food insecurity for many Pennsylvanians, and we expect the impact of the end of SNAP EA payments to be significant.

Additionally, the 2023 cost-of-living adjustment (COLA) for Social Security and Social Security Income (SSI), which is also set by the federal government, prompted an 8.7 percent increase to Social Security payments. SNAP eligibility thresholds — also set at the federal level — did not rise proportionally. Because of this, approximately 249,000 households will experience a decrease in their base SNAP benefits by an average of $40 per household, which will take effect in March when EAs end. The Department of Human Services (DHS) anticipates approximately 5,000 to 20,000 households will be disenrolled from SNAP due to the Social Security increase. These federal changes will primarily affect older Pennsylvanians and seniors.

Help is available for any individuals or families through Pennsylvania’s charitable food partners. Anyone who can donate food or resources is encouraged to help your local food banks and food pantries as they prepare to meet this potential additional need.

What are SNAP Emergency Allotments?

With funds made available due to the federal COVID-19 emergency, DHS began providing EAs as a second monthly payment to SNAP recipient households that were receiving benefits since March 2020. The EAs increased the SNAP budget amount to the maximum available amount for their household size or, since early 2021, were a minimum of $95. These payments were distributed separate from the initial payment as an extra payment each month.

Why are the extra payments ending?

The EAs are ending due to passage of the recent federal legislation. February will be the last month EAs are sent, and SNAP recipients will only receive one regular SNAP payment starting in March. This change will happen for all SNAP recipients, and SNAP households will receive letters via mail about the change in SNAP payments.

Update your personal information

Updating your personal information will help ensure households are receiving the maximum SNAP benefit based off their individual circumstances. Changes to household size, income, or expenses can be reported:

Resources for SNAP Recipients

DHS recognizes the impact these changes may have on households and wants to make sure families that need food assistance know where to go for help:

For Pregnant Women and Families

For Older Pennsylvanians

  • If you are a SNAP eligible senior citizen, apply to receive additional vouchers redeemable at more than 800 farm stands and more than 200 farmers’ markets in Pennsylvania. The Senior Food Box Program can also provide you with additional shelf-stable groceries. Learn more about these programs from the Pennsylvania Department of Agriculture.

Additional Food Resources

  • PA 211 — Connect with various local food resources through the United Way of Pennsylvania by calling 211 or visiting
  • Feeding PA — Find local food banks and other food assistance programs.
  • Ending Hunger and Food Security in Pennsylvania — Visit these sites from DHS and the PA Department of Agriculture for information on assistance programs and other resources.

How Can Pennsylvanians Help?

Support Your Local Food Network

Acting Secretary Valerie Arkoosh recently encouraged Pennsylvanians who are able to support their local food banks and pantries. Pennsylvania’s food network works tirelessly every day to be a resource and safety net for their communities. Small donations can grow into a big difference, so please do what you can so they can continue their life-saving work.

Help Spread the Word

DHS has developed a communications toolkit designed to help organizations, advocacy groups, government agencies, and others spread awareness about the changes to federal laws that will end the SNAP Emergency Allotment payments. Materials include newsletter text, social media posts, print documents, and more. Please use these materials to help educate and inform your audience about the upcoming changes.

What You Should Know About Unwinding Continuous Enrollment for Medicaid and CHIP

In the first year of the COVID-19 pandemic, the federal government provided an extra 6.2 percentage points in their Medicaid funding to states in exchange for allowing continuous enrollment – that is, pausing annual review of eligibility – for most Medicaid beneficiaries for as long as the official Public Health Emergency (PHE) declaration remained in place.  Since that change, enrollment in Medicaid and the Children’s Health Insurance Program (CHIP) has grown by almost 30 percent and, as of September 2022, nearly 91 million individuals were enrolled across the programs.

After several extensions, the PHE is set to expire in mid-April; however, new legislation calls for continuous enrollment and other pandemic-related flexibilities to end on March 31, 2023. Beginning on April 1, states claiming the temporary increase will be able to end Medicaid or CHIP enrollment for individuals, following a review of their eligibility. As explained in a letter to State Health Officials, states may begin disenrollment as early as February 1, 2023.  Once the process begins in each state, they will have 12 months to “unwind” expanded eligibility and return to their normal enrollment process.

Eligibility and renewal systems, staffing capacity, and investment in end-of-PHE preparedness vary across states. Because of the volume of new beneficiaries, federal health officials anticipate loss of coverage for millions of individuals and families.

To smooth the transition, the Centers for Medicare & Medicaid Services (CMS) is working with states to help them:

  1. Prepare for the renewal process and educate Medicaid/CHIP enrollees about the upcoming changes, and
  2. Ensure beneficiaries take the necessary steps to renew coverage, or transition to other coverage if they’re no longer eligible.

In its Communications Toolkit for Continuous Enrollment Unwinding, CMS identifies health care providers and clinics, local health departments, community-based organizations, and even schools and places of worship as effective avenues for outreach.

The Federal Office of Rural Health Policy will continue to monitor what’s happening, translate the unwinding process and its effects for rural stakeholders, and keep you up to date on significant news and deadlines.

Helpful Links

U.S. Department of Health & Human Services – Projected Enrollment Effects and Policy Approaches

Centers for Medicare & Medicaid Services guidance, official documents, and communications toolkits in seven languages and Engaging Managed Care Plans to Maximize Continuity of Coverage

Federal Communications Commission – Action to Ensure Americans Receive Critical Information on Health Care Coverage

Georgetown Health Policy Institute50 State Unwinding Tracker

Kaiser Family Foundation – 10 Things to Know about the Unwinding of the Medicaid Continuous Enrollment Provision

Newly Released MMWR Article Focuses on Rural/Urban Comparison of Adult Leisure Time

TitlePrevalence of Meeting Aerobic, Muscle-Strengthening, and Combined Physical Activity Guidelines During Leisure Time Among Adults, by Rural-Urban Classification and Region — United States, 2020

Summary: Physical activity is important in health promotion and disease prevention; rural-urban and regional disparities among adults in meeting the combined leisure time physical activity guidelines exist. Analysis of 2020 National Health Interview Survey data found a low proportion of U.S. adults met leisure-time aerobic, muscle-strengthening, and combined physical activity guidelines. Residents in larger metropolitan areas and in the West U.S. Census Bureau region were more likely than were those in less populated urban and rural areas or other regions to meet these guidelines. Rural residents might benefit from investments in structural capacity and policy, systems, and environment change to support leisure-time physical activity.

Suggested Citation: Abildso CG, Daily SM, Umstattd Meyer MR, Perry CK, Eyler A. Prevalence of Meeting Aerobic, Muscle-Strengthening, and Combined Physical Activity Guidelines During Leisure Time Among Adults, by Rural-Urban Classification and Region — United States, 2020. MMWR Morb Mortal Wkly Rep 2023;72:85–89. DOI:

Join ARC for In-Person Workshops Across Appalachia

Getting the Grant: Successfully Applying for ARC Funding Opportunities is an in-person workshop series designed to help prospective applicants submit strong applications for POWER, INSPIRE, and ARISE funding in 2023.

ARC is traveling to three Appalachian subregions to help more potential applicants meet with our grant staff, ask questions, and hear helpful tips for securing funding:

  • February 23, 2023: Southern Appalachia Pre-Application Workshop (Belden, MS)
  • February 28, 2023: Central Appalachia Pre-Application Workshop (Knoxville, TN)
  • March 2, 2023: Northern Appalachia Pre-Application Workshop (Pittsburgh, PA)

Click here to register.