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Rep. Mariannette Miller-Meeks, R-Iowa, participated in a fireside chat during the afternoon plenary session May 5 at the 2025 AHA Annual Membership meeting. As a member of the House Energy and Commerce Committee, Miller-Meeks spoke on how her experience as a physician in rural areas can be a benefit in upcoming committee discussions on addressing the $880 billion in savings the committee is tasked with earmarking within the reconciliation bill, which could lead to significant cuts to Medicaid.

Discussing workforce retention, recruitment and addressing those challenges, particularly in rural settings, would be beneficial, she said. General knowledge and experience with the health care system would also help. “As doctors, you know a lot about the delivery of care and what kind of care, but you don't always know about the system of care, and that’s the entirety of the system — whether it be within the hospital, outpatient or the insurance part,” she said. “It's extraordinarily complex, all these interwoven parts, so I think understanding the complexity is helpful.”

Other issues Miller-Meeks spoke on included the unique patient payer mix in rural areas, which she said is predominantly low-income individuals on Medicare and Medicaid. Despite those challenges, Miller-Meeks was optimistic about finding savings that would not induce significant harm to Medicaid, such as altering the Centers for Medicare & Medicaid Services’ minimum nurse staffing rule and establishing work requirements for Medicaid.