Why It Matters
Rural health clinics face an existential crisis that makes the National Association of Rural Health Clinics’s (NARHC) lobbying timely. More than 700 rural hospitals are at risk of closing, and 47 states are projected to have primary care physician shortages by 2037. Legislative solutions around reimbursement and workforce support are critical to preventing further clinic closures and access collapse in underserved areas.
By the Numbers
The NARHC paid $100,000 to Capitol Associates Inc. for final quarter 2025 lobbying work. Over 22 years, NARHC has reported 78 total lobbying disclosures and $3.66 million in total expenditures with consistent spending patterns. NARHC’s lobbying has historically centered on Medicare/Medicaid reimbursement (77 disclosures), budget appropriations (70 disclosures), and broader health issues (67 disclosures).
The Agenda
In final quarter of 2025, NARHC is lobbying on core healthcare policy issues affecting its 5,200+ member clinics. Its key priorities include:
- Telehealth permanence: Supporting the CONNECT for Health Act to make pandemic-era telehealth flexibilities permanent.
- Workforce development: Advocating for bills like the RNs for Rural Health Act to address staffing shortages.
- Financial stability: Supporting the Save America’s Rural Hospitals Act to reverse Medicare cuts.
- Administrative burden reduction: Lobbying for the Improving Seniors Timely Access to Care Act to streamline Medicare Advantage prior authorization.
Broader Context
There is a severe rural healthcare crisis, which makes NARHC’s lobbying urgent. 62 rural hospitals closed from 2017 to 2024 compared to only 10 openings. Congress has authorized an $83 billion rural health fund for telehealth expansion and workforce development. However, a "Telehealth Policy Cliff" threatened to expire pandemic-era Medicare flexibilities, prompting Congress to extend them through January 2026. Insurers made nearly 53 million prior authorization requests in 2024, creating administrative barriers for rural providers.
Between The Lines
Congress is actively legislating on nearly every issue NARHC is lobbying on. The House Energy and Commerce Health Subcommittee held a July 2025 hearing on telehealth reauthorization, while a House Ways and Means hearing addressed Medicare Advantage prior authorization burdens. Key legislation like the CONNECT for Health Act and Save America’s Rural Hospitals Act align directly with NARHC’s priorities.
Competitive Landscape
NARHC stands as the most active organization lobbying specifically for Rural Health Clinics. The broader rural health advocacy space includes the National Association of Community Health Centers Inc. and other organizations with complementary interests.
The Bottom Line
NARHC’s $100,000 final quarter 2025 payment represents the latest installment in a 22-year exclusive relationship focused on Medicare/Medicaid policy, telehealth reimbursement, and workforce development. While bipartisan support appears strong in Congress, underlying policy pressures create contradictions that NARHC’s sustained advocacy efforts seek to counter.
Access the Legis1 platform for comprehensive political news, data, and insights.