Hospitals must start paying back the millions in federal loans that were provided at the beginning of the pandemic, but experts are worried that these payments, which will be docked from regular Medicare payments until they are completely paid off, will cause rural hospitals to struggle. Chip Kahn, President of the American Federation of Hospitals, expressed concerns that hospitals are in the middle of these COVID-19 surges and that being forced to repay these loans is “going to kill them.” NRHA is advocating for MAAP loan relief for rural hospitals in the upcoming COVID-19 relief package. However, thus far, Republicans and Democrats have failed to agree on what to include and how much to spend on the relief package.