PHOENIX — The U.S government has some huge decisions looming on the horizon, which could have even bigger implications for rural hospitals across the country, and the more than 50 million people they serve. The field can't afford to remain on the sidelines.

Here at the AHA’s 29th Rural Health Care Leadership Conference, association staffers gave the 780 or so attendees the skinny on some of the latest activity in D.C., including the administration’s new budget. There was a lot to take in during the rapid-fire rundown of legislative updates, but one key takeaway was that rural hospital leaders can’t remain silent.

“The next several months, Congress is going to be making decisions that will affect your ability to continue to provide patient care and to take care of the needs in your community,” said recently retired AHA CEO Rich Umbdenstock. “The reality is that, if Congress doesn’t hear from us, they will assume that you’re OK with what they are doing. That’s not how we want to leave things.”

Just yesterday, the Obama Administration proposed a 2017 budget that spells out $420 billion in cuts to Medicare over the next decade. In a statement Tuesday, the American Hospital Association called those cuts “ill advised” and “hampering,” with the potential to “harm care for vulnerable populations in rural communities.”

Other topics tackled Tuesday by the AHA included the group’s push to keep “vital funding” for small and rural hospitals, and ensure that critical-access hospitals are paid at least 101 percent of costs by Medicare, with no changes to critical access mileage criteria. The administration’s budget, meanwhile, proposes reducing CAH payments to 100 percent of reasonable costs to cut $1.67 billion over 19 years. The budget also asks to prohibit the designation of such hospitals for those facilities that are less than 10 miles from another hospital, reducing spending by $880 million over the same time period, said Priya Bathija, senior association director of policy for the AHA.

I’m not going to run through all of the details, but you can find some of the AHA’s positions on rural health bills here. Umbdenstock and the AHA urged rural leaders to stay abreast of legislation, find out whether their representatives are supporting important rural legislation, download the association’s Action Center mobile app, and use it to share their messages to support the rural segment.

“Many of you I know have great relationships with your federal delegation and you know best how to reach them and how to communicate with them,” Umbdenstock said. “For others who may not have built those relationships, it’s extremely important. They need to hear from you and Congress has to hear one coordinated, consistent, constant message on rural health issues from all of us.”