Idaho’s rural doctor shortage could get much worse. Congress needs to fix Medicare | Opinion
If last year’s elections proved one thing, it’s that policymakers in DC can no longer ignore rural Americans. For our patients and communities, that includes ensuring access to high-quality, affordable health care — something that every American, not just those living in larger urban and suburban areas, should have.
This year, Congress and the Trump administration should work to improve healthcare access, stabilize the Medicare system and address the growing doctor shortage that particularly impacts rural communities throughout Idaho and nationwide. Otherwise, this growing instability in Medicare will only continue to make it harder for patients to get the healthcare they need.
Idaho’s population is becoming increasingly sicker with multiple, chronic conditions, and sadly our state ranks last in the nation in access to primary care physicians. Many factors are driving the growing physician shortage, including crippling inflation, labor and workforce challenges, and more doctors retiring with fewer joining the profession. This shortage has been a problem here for a long time — but is only getting worse as Idaho’s physicians grow older.
And while the supply of doctors dwindles, those who choose to work in rural communities must also contend with red tape in Medicare and an unlevel payment system that devalues the care and services they provide. Real reforms must be made to the Medicare Physician Fee Schedule (MPFS) to address these concerns. If not, more local doctors’ offices will be forced to scale back their staff and services, stop seeing new Medicare patients or else close their doors entirely.
For some bizarre reason, physicians are the only kind of providers that don’t receive an annual inflationary update to their Medicare payments. All other providers, including hospitals and nursing homes, receive such payment updates, which helps them account for the rising cost of care. Yet, even as practice costs continue to soar, physician reimbursements continue to fall.
In fact, Medicare payments to physicians actually declined by 33% between 2001 and 2025 — even after adjusting for inflation. Physicians have been routinely targeted with additional payment cuts, the most recent of which (a 2.8% reduction) went into effect on January 1 after Congress failed to stop it in December. Alarmingly, lawmakers again missed the opportunity to address the cuts in its continuing resolution in mid-March.
Washington cannot expect doctors to keep doing more with fewer and fewer resources. They need a payment system that covers the true cost of providing medical care. Failure to address this dire situation will mean that the physician shortage facing rural communities will only continue to worsen.
Thankfully, Sen. Mike Crapo highlighted the pressing need for Congress to “streamline clinician payment systems,” “improve primary care,” and “provide Medicare doctors with long-term payment stability.” Fixing the broken Medicare Physician Fee Schedule (MPFS) will help achieve all these goals — and make our nation healthier.
I’m grateful that Idaho doctors have Crapo’s support and am hopeful that he can help push for long-overdue reforms that ensure physicians can continue serving our patients and communities. Congress should pass the Medicare Patient Access and Practice Stabilization Act as soon as possible. This bipartisan legislation, which has the support of hundreds of lawmakers, healthcare organizations and the GOP Doctors Caucus, will retroactively address this year’s devastating cuts to physicians’ Medicare payments. Once lawmakers stop the bleeding, they should also work quickly to pass long-term Medicare reform that ensures a fair and effective payment system that strengthens rural Americans’ access to care.
All of this will be critical to strengthening rural communities that have been ignored for too long.