The Harris campaign unveiled several rural health policy proposals this week that public health experts say could have an impact in Maine.

Yvonne Jonk, director of the Maine Rural Health Research Center at the University of Southern Maine, said that the focus on rural health care is welcome in light of the struggles that many residents face in getting access to health care.

Vice President Kamala Harris, a Democrat, is facing former President Donald Trump in the November election, and both candidates have tried to appeal to rural voters who could be key to winning in several battleground states. Trump has strong support in many rural areas across the country, including in Maine’s 2nd Congressional District, while Harris and her running mate, Minnesota Gov. Tim Walz, have worked to make inroads with those voters.

Paramedic Rebecca Quinn, right, fills out patient charts as her partner, Nathaniel Lombardi, an advanced EMT, center, trains Chris Wildes at Delta Ambulance in Waterville in 2020. Michael G. Seamans/Morning Sentinel, file

The Harris campaign rolled out a series of policy proposals on Tuesday that included investing in rural ambulance services, financial support for rural hospitals, health care workforce incentives, payment reforms for independent pharmacies and expanding telehealth services.

Rural hospitals across the country and in Maine have closed or cut back services, and rural ambulance providers have a difficult time making ends meet.

Jonk’s research on the critical problems facing rural ambulance providers was cited by the Harris campaign.

“EMS services have not been considered to be part of the health care arena,” Jonk said. “They’re not reimbursed for much of the work they do. They are only reimbursed when they take patients to a hospital. It’s not a financially sustainable model.”

Jonk said for instance, if paramedics respond to a 911 call, perform CPR and revive the patient, but the patient refuses to be transported to a hospital, the EMS service would not be reimbursed.

Harris’ proposal calls for raising reimbursement rates for EMS providers.

Also, rural hospitals would receive a boost by strengthening a federal rural emergency hospital designation that comes with additional funding, the Harris campaign said. No details were provided about how this would be accomplished.

Responding on behalf of the Trump campaign, Anna Kelly, spokesperson for the Republican National Committee, said Harris “is back at it again, lying about plans to make health care and overall costs more affordable for rural communities.

“(Former) President Trump will fight to get Americans the best drug prices in the world that are produced at the highest standard by manufacturing them here in the USA,”  Kelly said in a written statement.

The Harris plan would also increase scholarships, loan forgiveness and training funding to jump-start incentives that encourage recent graduates in the health care field to work in rural areas. The goal is to add 10,000 health care workers to rural areas across the country.

Programs already exist to help spur the rural health workforce, but the programs need to be more robust to attract additional workers to rural areas, Jonk said.

“These are pretty modest goals, but achievable,” Jonk said “These programs do actually work.”

For independent pharmacies, which make up more than 75% of pharmacies in rural areas, Harris’ plan calls for improved reimbursement rates by regulating pharmacy benefit managers. Pharmacy benefit managers are middlemen who manage prescription drug benefits for health insurance companies.

Amelia Arnold, vice president of operations for Community Pharmacies, an independent chain with eight Maine locations, including in Gorham and Saco, said there needs to be “meaningful payment reform” for pharmacies regardless of who wins the presidency.

Arnold said for many medications, “we are getting reimbursed less than what the drugs cost.”

“I am glad that pharmacies are being recognized as an integral part of care, because we are at a tipping point,” Arnold said. “Every single day, multiple times per day, we are losing money when filling prescriptions.”

Harris’ campaign says her plan would reverse the closures of independent pharmacies, and increase the number of independent pharmacies by 15%.