WASHINGTON, D.C. – On Tuesday a bipartisan group in Congress introduced legislation to give rural Medicare and Medicaid beneficiaries equal representation on the boards that set policy for the public programs.

The group included Congressman Mike Thompson (D-Calif.), co-chair of the Bipartisan Rural Health Care Coalition who also represents California's First Congressional District – which includes Lake County – in Congress, along with Reps. Greg Walden (R-Ore.), Cathy McMorris Rodgers (R-Wash.), Mike Ross (D-Ark.), and Jim Matheson (D-Utah).

Currently, the Medicare Payment Advisory Commission (MedPAC) and the Medicaid and CHIP Payment and Access Commission (MACPAC) establish policy and provide recommendations for improving Medicare and Medicaid.

Both boards have been instructed by Congress to balance the unique needs of urban and rural beneficiaries.

But in practice, rural representation on the boards lags far behind the actual number of rural enrollees in Medicare and Medicaid.

• About 26 percent of Medicare recipients are from rural America, yet according to the National Rural Health Association (NRHA) just 3 of the 17 MedPAC board members have significant experience delivering health care in rural America and can adequately represent the interests of rural patients.

• About 20 percent of Medicaid recipients are from rural America. The MACPAC board also has 17 members.

In response to this disparity, Thompson and a bipartisan group of lawmakers have introduced the Rural Representation and Accountability Act, which would ensure the proportion of members on MedPAC and MACPAC representing rural beneficiaries is no less than the proportion of the total number of Medicare and Medicaid patients residing in rural areas:

• With about 26 percent of Medicare recipients from rural America, this legislation would require that at least 5 of MedPAC’s 17 board members adequately represent rural patients.

• With about 20 percent of Medicaid recipients from rural America, this legislation would require that at least 4 of MACPAC’s 17 board members adequately represent rural patients.

“Rural Americans deserve advocates who know the needs of rural patients,” Thompson said. “Unfortunately, many of MedPAC and MACPAC’s board members do not have experience delivering health care in rural areas. It’s time to take action to ensure rural families in California and across the country have a voice at the table to ensure their unique health care challenges are being addressed.”

In addition to providing rural beneficiaries with proportionate representation, the Rural Representation and Transparency Act would also create greater transparency in how MedPAC and MACPAC operate.

The bill would require both boards to provide full and timely public disclosure of its proceedings on the Internet, post either audio or video coverage of its proceedings online and post transcripts of its proceedings online.