Health care

What I see

The availability of health care in rural areas is what I'm most passionate about, and it's the thing I know best.

Here is what it looks like from where I sit. A person puts off a problem. Not because they don't care, but because there's no appointment for six weeks, or the nearest provider is forty minutes away and the car isn't reliable, or they'd have to take a day off work they can't afford to take. By the time I see them, the small problem is a big one. That is the most expensive kind of medicine there is, and it's also the cruelest.

Two reasons people here can't get care are accessibility to health care providers and transportation. Those are two different problems and they both need fixing.

Providers are leaving, and Missouri is pushing them out

Missouri has a provider shortage that isn't an accident. Missouri consistently ranks among the worst states for health care access, and in a district like ours you feel that ranking in a waiting room.

In the 2026 legislative session, a bipartisan bill in the Senate — SB 979 — noted that 111 of Missouri's 114 counties are federally designated health professional shortage areas, and that Missouri would be the 40th state to let experienced nurse practitioners practice independently. Every state bordering Missouri except Tennessee already allows it. That bill cleared committee but died without a floor vote.

I've testified on this. I told a House committee in 2024 that letting certain providers practice to the full extent of their education and training would cost the state nothing and would address "the continued attrition of healthcare providers moving out of state to practice due to legal restrictions to practice."

That's not a theory to me. I've watched good nurse practitioners leave Missouri for Arkansas or Illinois because they could actually do their jobs there. Every one of them is a clinic that doesn't open in a town like ours.

I don't want to take anything away from physicians. We need more of them here too, and I'd work on that just as hard. But when there is no doctor within thirty miles, the argument that a nurse practitioner shouldn't be allowed to see the patient in front of her stops being about safety.

Having a baby in the Bootheel

The hardest thing to explain to somebody from outside this area is what has happened to maternity care.

The Missouri Bootheel has been described as a "maternal desert." Some counties in this part of the state have no hospital that delivers babies and no obstetric provider at all. Statewide, 51% of Missouri counties are maternity care deserts, compared with 35% nationally. Infant mortality in parts of the Bootheel has run as high as 11 per 1,000 births. Most rural hospitals in Missouri no longer deliver babies, because delivering babies is expensive and the reimbursement isn't there.

Missouri Delta Medical Center in Sikeston does still deliver babies, and I'm grateful for it. But a young mother in this district may be an hour from that door, in labor, at night.

This is fixable. It takes money, it takes providers, and it takes somebody in Jefferson City who will say out loud that it's happening.

Our hospitals

In December 2025, Pemiscot Memorial Hospital — a hospital just south of us in Pemiscot County — converted to Rural Emergency Hospital status. I want to be straight with people about what that means, because it's been described both as a rescue and as a closure and it's neither. The conversion let the hospital keep its doors and its emergency room open by trading away its inpatient beds in exchange for better emergency reimbursement. The ER is still there. If you need to be admitted, you go somewhere else.

I'm glad the ER is open. I'd rather it hadn't come to that choice.

This isn't only our problem. About 13% of Missouri's rural hospitals have closed in the past decade, and roughly half of the ones still standing operate at a loss — with the trouble especially concentrated in southeast Missouri. Federal health funding cuts now on the books are projected to pull far more money out of rural health care than the new Rural Health Transformation Program will put back; Missouri's share of that program is about $216 million over five years, against national health funding losses estimated in the trillions over ten years.

Medicaid is not an abstraction in a district this poor. When Medicaid gets cut, rural hospitals are the first thing to break, and then everybody's emergency room is farther away — including yours, whether you're on Medicaid or not.

Getting there

A doctor you can't reach is not a doctor. Transportation is half of rural health access and it almost never gets talked about in Jefferson City. If a person has no car, or can't drive anymore, or the only appointment is in Cape Girardeau at 9 a.m., the care might as well not exist.

I'd rather move care to people than keep asking people to move themselves. Health screenings at churches and community events, like the ones we did at the back-to-school bash this August, work. So do mobile clinics, telehealth where the internet holds up, and paying for medical transportation instead of pretending it's free.

What I’ll do