On Motion to Suspend the Rules and Pass — H R 2493 — Improving Care in Rural America Reauthorization Act
Improving Care in Rural America Reauthorization Act of 2025
In plain language
- House bill in the 119th Congress.
- Reauthorizes through FY2030 grant programs administered by the Health Resources and Services Administration (HRSA) that provide funding.
- House passed it on Apr 21, 2026 (substantive).
Official summary (Congressional Research Service)
Improving Care in Rural America Reauthorization Act of 2025 This bill reauthorizes through FY2030 grant programs administered by the Health Resources and Services Administration (HRSA) that provide funding to health care service providers and related entities in rural areas. Specifically, the bill reauthorizes grants for expanding the delivery of health care services in rural areas, developing integrated health care networks (i.e., collaborative groups of local health care organizations) in rural areas, and improving the quality of services provided by small health care providers in rural areas. Also, the bill requires HRSA to ensure that grant funds for expanding services or developing health care networks are used to (1) meet the health care needs of underserved populations, and (2) engage such populations in the planning and implementation of related activities.
Roll-call breakdown
Democrat: 207 · Independent: 1 · Republican: 198
Republican: 4
—
Democrat: 6 · Republican: 14
How each member voted (430)
Yea (406)
- Aaron Bean (Republican–FL)
- Abraham J. Hamadeh (Republican–AZ)
- Adam Gray (Democrat–CA)
- Adam Smith (Democrat–WA)
- Addison P. McDowell (Republican–NC)
- Adelita S. Grijalva (Democrat–AZ)
- Adrian Smith (Republican–NE)
- Adriano Espaillat (Democrat–NY)
- Al Green (Democrat–TX)
- Alexandria Ocasio-Cortez (Democrat–NY)
- Alma S. Adams (Democrat–NC)
- Ami Bera (Democrat–CA)
- Analilia Mejia (Democrat–NJ)
- André Carson (Democrat–IN)
- Andrea Salinas (Democrat–OR)
- Andrew Ogles (Republican–TN)
- Andrew R. Garbarino (Republican–NY)
- Andrew S. Clyde (Republican–GA)
- Andy Barr (Republican–KY)
- Andy Harris (Republican–MD)
- Angie Craig (Democrat–MN)
- Ann Wagner (Republican–MO)
- Anna Paulina Luna (Republican–FL)
- April McClain Delaney (Democrat–MD)
- Ashley Hinson (Republican–IA)
- August Pfluger (Republican–TX)
- Austin Scott (Republican–GA)
- Ayanna Pressley (Democrat–MA)
- Barry Loudermilk (Republican–GA)
- Barry Moore (Republican–AL)
- Becca Balint (Democrat–VT)
- Bennie G. Thompson (Democrat–MS)
- Beth Van Duyne (Republican–TX)
- Betty McCollum (Democrat–MN)
- Bill Foster (Democrat–IL)
- Bill Huizenga (Republican–MI)
- Blake D. Moore (Republican–UT)
- Bonnie Watson Coleman (Democrat–NJ)
- Brad Finstad (Republican–MN)
- Brad Knott (Republican–NC)
- Brad Sherman (Democrat–CA)
- Bradley Scott Schneider (Democrat–IL)
- Brandon Gill (Republican–TX)
- Brendan F. Boyle (Democrat–PA)
- Brett Guthrie (Republican–KY)
- Brian Babin (Republican–TX)
- Brian J. Mast (Republican–FL)
- Brian Jack (Republican–GA)
- Brian K. Fitzpatrick (Republican–PA)
- Brittany Pettersen (Democrat–CO)
- Bruce Westerman (Republican–AR)
- Bryan Steil (Republican–WI)
- Burgess Owens (Republican–UT)
- Byron Donalds (Republican–FL)
- Carlos A. Gimenez (Republican–FL)
- Carol D. Miller (Republican–WV)
- Celeste Maloy (Republican–UT)
- Charles J. "Chuck" Fleischmann (Republican–TN)
- Chellie Pingree (Democrat–ME)
- Chip Roy (Republican–TX)
- Chris Pappas (Democrat–NH)
- Chrissy Houlahan (Democrat–PA)
- Christian D. Menefee (Democrat–TX)
- Christopher H. Smith (Republican–NJ)
- Christopher R. Deluzio (Democrat–PA)
- Chuck Edwards (Republican–NC)
- Claudia Tenney (Republican–NY)
- Clay Fuller (Republican–GA)
- Clay Higgins (Republican–LA)
- Cleo Fields (Democrat–LA)
- Cliff Bentz (Republican–OR)
- Cory Mills (Republican–FL)
- Craig A. Goldman (Republican–TX)
- Dale W. Strong (Republican–AL)
- Daniel Meuser (Republican–PA)
- Daniel Webster (Republican–FL)
- Danny K. Davis (Democrat–IL)
- Darin LaHood (Republican–IL)
- Darrell Issa (Republican–CA)
- Darren Soto (Democrat–FL)
- Dave Min (Democrat–CA)
- David G. Valadao (Republican–CA)
- David J. Taylor (Republican–OH)
- David Kustoff (Republican–TN)
- David P. Joyce (Republican–OH)
- David Rouzer (Republican–NC)
- David Schweikert (Republican–AZ)
- David Scott (Democrat–GA)
- Debbie Dingell (Democrat–MI)
- Debbie Wasserman Schultz (Democrat–FL)
- Deborah K. Ross (Democrat–NC)
- Delia C. Ramirez (Democrat–IL)
- Derek Schmidt (Republican–KS)
- Derek Tran (Democrat–CA)
- Derrick Van Orden (Republican–WI)
- Diana DeGette (Democrat–CO)
- Diana Harshbarger (Republican–TN)
- Dina Titus (Democrat–NV)
- Don Bacon (Republican–NE)
- Donald G. Davis (Democrat–NC)
- Donald Norcross (Democrat–NJ)
- Donald S. Beyer, Jr. (Democrat–VA)
- Doris O. Matsui (Democrat–CA)
- Dusty Johnson (Republican–SD)
- Dwight Evans (Democrat–PA)
- Earl L. "Buddy" Carter (Republican–GA)
- Ed Case (Democrat–HI)
- Elijah Crane (Republican–AZ)
- Elise M. Stefanik (Republican–NY)
- Emanuel Cleaver (Democrat–MO)
- Emilia Strong Sykes (Democrat–OH)
- Emily Randall (Democrat–WA)
- Eric A. "Rick" Crawford (Republican–AR)
- Eric Sorensen (Democrat–IL)
- Erin Houchin (Republican–IN)
- Eugene Simon Vindman (Democrat–VA)
- Frank D. Lucas (Republican–OK)
- Frank J. Mrvan (Democrat–IN)
- Frank Pallone, Jr. (Democrat–NJ)
- Gabe Amo (Democrat–RI)
- Gabe Evans (Republican–CO)
- Gabe Vasquez (Democrat–NM)
- Gary J. Palmer (Republican–AL)
- George Latimer (Democrat–NY)
- George Whitesides (Democrat–CA)
- Gilbert Ray Cisneros, Jr. (Democrat–CA)
- Glenn Grothman (Republican–WI)
- Glenn Ivey (Democrat–MD)
- Glenn Thompson (Republican–PA)
- Grace Meng (Democrat–NY)
- Greg Casar (Democrat–TX)
- Greg Landsman (Democrat–OH)
- Greg Stanton (Democrat–AZ)
- Gregory F. Murphy (Republican–NC)
- Gregory W. Meeks (Democrat–NY)
- Gus M. Bilirakis (Republican–FL)
- Guy Reschenthaler (Republican–PA)
- Gwen Moore (Democrat–WI)
- Hakeem S. Jeffries (Democrat–NY)
- Haley M. Stevens (Democrat–MI)
- Harold Rogers (Republican–KY)
- Harriet M. Hageman (Republican–WY)
- Henry C. "Hank" Johnson, Jr. (Democrat–GA)
- Henry Cuellar (Democrat–TX)
- Herbert C. Conaway, Jr. (Democrat–NJ)
- Hillary J. Scholten (Democrat–MI)
- Ilhan Omar (Democrat–MN)
- J. French Hill (Republican–AR)
- J. Luis Correa (Democrat–CA)
- Jack Bergman (Republican–MI)
- Jahana Hayes (Democrat–CT)
- Jake Auchincloss (Democrat–MA)
- Jake Ellzey (Republican–TX)
- James A. Himes (Democrat–CT)
- James Comer (Republican–KY)
- James E. Clyburn (Democrat–SC)
- James P. McGovern (Democrat–MA)
- James R. Baird (Republican–IN)
- James R. Walkinshaw (Democrat–VA)
- Jamie Raskin (Democrat–MD)
- Janelle S. Bynum (Democrat–OR)
- Jared Huffman (Democrat–CA)
- Jared Moskowitz (Democrat–FL)
- Jasmine Crockett (Democrat–TX)
- Jason Crow (Democrat–CO)
- Jason Smith (Republican–MO)
- Jay Obernolte (Republican–CA)
- Jeff Crank (Republican–CO)
- Jeff Hurd (Republican–CO)
- Jefferson Shreve (Republican–IN)
- Jefferson Van Drew (Republican–NJ)
- Jennifer L. McClellan (Democrat–VA)
- Jerrold Nadler (Democrat–NY)
- Jesús G. "Chuy" García (Democrat–IL)
- Jill N. Tokuda (Democrat–HI)
- Jim Costa (Democrat–CA)
- Jim Jordan (Republican–OH)
- Jimmy Gomez (Democrat–CA)
- Jimmy Panetta (Democrat–CA)
- Jimmy Patronis (Republican–FL)
- Joaquin Castro (Democrat–TX)
- Jodey C. Arrington (Republican–TX)
- Joe Courtney (Democrat–CT)
- Joe Neguse (Democrat–CO)
- Joe Wilson (Republican–SC)
- John B. Larson (Democrat–CT)
- John Garamendi (Democrat–CA)
- John H. Rutherford (Republican–FL)
- John James (Republican–MI)
- John Joyce (Republican–PA)
- John R. Carter (Republican–TX)
- John R. Moolenaar (Republican–MI)
- John W. Mannion (Democrat–NY)
- John W. Rose (Republican–TN)
- Johnny Olszewski, Jr. (Democrat–MD)
- Jonathan L. Jackson (Democrat–IL)
- Joseph D. Morelle (Democrat–NY)
- Josh Gottheimer (Democrat–NJ)
- Josh Harder (Democrat–CA)
- Josh Riley (Democrat–NY)
- Joyce Beatty (Democrat–OH)
- Juan Ciscomani (Republican–AZ)
- Juan Vargas (Democrat–CA)
- Judy Chu (Democrat–CA)
- Julia Letlow (Republican–LA)
- Julie Fedorchak (Republican–ND)
- Julie Johnson (Democrat–TX)
- Kat Cammack (Republican–FL)
- Katherine M. Clark (Democrat–MA)
- Kathy Castor (Democrat–FL)
- Kelly Morrison (Democrat–MN)
- Ken Calvert (Republican–CA)
- Kevin Hern (Republican–OK)
- Kevin Kiley (Independent–CA)
- Kevin Mullin (Democrat–CA)
- Kim Schrier (Democrat–WA)
- Kristen McDonald Rivet (Democrat–MI)
- Kweisi Mfume (Democrat–MD)
- LaMonica McIver (Democrat–NJ)
- Lance Gooden (Republican–TX)
- Lateefah Simon (Democrat–CA)
- Laura Friedman (Democrat–CA)
- Laura Gillen (Democrat–NY)
- Laurel M. Lee (Republican–FL)
- Lauren Boebert (Republican–CO)
- Lauren Underwood (Democrat–IL)
- Linda T. Sánchez (Democrat–CA)
- Lisa C. McClain (Republican–MI)
- Lloyd Doggett (Democrat–TX)
- Lloyd Smucker (Republican–PA)
- Lois Frankel (Democrat–FL)
- Lori Trahan (Democrat–MA)
- Lucy McBath (Democrat–GA)
- Luz M. Rivas (Democrat–CA)
- Madeleine Dean (Democrat–PA)
- Maggie Goodlander (Democrat–NH)
- Marc A. Veasey (Democrat–TX)
- Marcy Kaptur (Democrat–OH)
- Maria Elvira Salazar (Republican–FL)
- Mariannette Miller-Meeks (Republican–IA)
- Marie Gluesenkamp Perez (Democrat–WA)
- Marilyn Strickland (Democrat–WA)
- Mario Diaz-Balart (Republican–FL)
- Mark Alford (Republican–MO)
- Mark B. Messmer (Republican–IN)
- Mark DeSaulnier (Democrat–CA)
- Mark E. Amodei (Republican–NV)
- Mark Harris (Republican–NC)
- Mark Pocan (Democrat–WI)
- Mark Takano (Democrat–CA)
- Marlin A. Stutzman (Republican–IN)
- Mary E. Miller (Republican–IL)
- Mary Gay Scanlon (Democrat–PA)
- Matt Van Epps (Republican–TN)
- Max L. Miller (Republican–OH)
- Maxine Dexter (Democrat–OR)
- Maxine Waters (Democrat–CA)
- Maxwell Frost (Democrat–FL)
- Melanie A. Stansbury (Democrat–NM)
- Michael A. Rulli (Republican–OH)
- Michael Baumgartner (Republican–WA)
- Michael Cloud (Republican–TX)
- Michael Guest (Republican–MS)
- Michael K. Simpson (Republican–ID)
- Michael Lawler (Republican–NY)
- Michael R. Turner (Republican–OH)
- Michelle Fischbach (Republican–MN)
- Mike Bost (Republican–IL)
- Mike Carey (Republican–OH)
- Mike Collins (Republican–GA)
- Mike Ezell (Republican–MS)
- Mike Flood (Republican–NE)
- Mike Haridopolos (Republican–FL)
- Mike Kelly (Republican–PA)
- Mike Kennedy (Republican–UT)
- Mike Levin (Democrat–CA)
- Mike Quigley (Democrat–IL)
- Mike Rogers (Republican–AL)
- Mike Thompson (Democrat–CA)
- Morgan Luttrell (Republican–TX)
- Morgan McGarvey (Democrat–KY)
- Nancy Pelosi (Democrat–CA)
- Nanette Diaz Barragán (Democrat–CA)
- Nathaniel Moran (Republican–TX)
- Nellie Pou (Democrat–NJ)
- Nicholas A. Langworthy (Republican–NY)
- Nicholas J. Begich III (Republican–AK)
- Nick LaLota (Republican–NY)
- Nicole Malliotakis (Republican–NY)
- Nikema Williams (Democrat–GA)
- Nikki Budzinski (Democrat–IL)
- Norma J. Torres (Democrat–CA)
- Nydia M. Velázquez (Democrat–NY)
- Pat Fallon (Republican–TX)
- Pat Harrigan (Republican–NC)
- Patrick Ryan (Democrat–NY)
- Paul A. Gosar (Republican–AZ)
- Paul Tonko (Democrat–NY)
- Pete Aguilar (Democrat–CA)
- Pete Sessions (Republican–TX)
- Pete Stauber (Republican–MN)
- Pramila Jayapal (Democrat–WA)
- Raja Krishnamoorthi (Democrat–IL)
- Randy Feenstra (Republican–IA)
- Randy Fine (Republican–FL)
- Randy K. Weber, Sr. (Republican–TX)
- Rashida Tlaib (Democrat–MI)
- Raul Ruiz (Democrat–CA)
- Richard E. Neal (Democrat–MA)
- Richard Hudson (Republican–NC)
- Richard McCormick (Republican–GA)
- Rick Larsen (Democrat–WA)
- Rick W. Allen (Republican–GA)
- Riley M. Moore (Republican–WV)
- Ritchie Torres (Democrat–NY)
- Ro Khanna (Democrat–CA)
- Robert B. Aderholt (Republican–AL)
- Robert C. "Bobby" Scott (Democrat–VA)
- Robert E. Latta (Republican–OH)
- Robert F. Onder, Jr. (Republican–MO)
- Robert Garcia (Democrat–CA)
- Robert Menendez (Democrat–NJ)
- Robert P. Bresnahan, Jr. (Republican–PA)
- Robin L. Kelly (Democrat–IL)
- Roger Williams (Republican–TX)
- Ron Estes (Republican–KS)
- Ronny Jackson (Republican–TX)
- Rosa L. DeLauro (Democrat–CT)
- Rudy Yakym III (Republican–IN)
- Russ Fulcher (Republican–ID)
- Russell Fry (Republican–SC)
- Ryan K. Zinke (Republican–MT)
- Ryan Mackenzie (Republican–PA)
- Salud O. Carbajal (Democrat–CA)
- Sam Graves (Republican–MO)
- Sam T. Liccardo (Democrat–CA)
- Sanford D. Bishop, Jr. (Democrat–GA)
- Sara Jacobs (Democrat–CA)
- Sarah Elfreth (Democrat–MD)
- Sarah McBride (Democrat–DE)
- Scott DesJarlais (Republican–TN)
- Scott Fitzgerald (Republican–WI)
- Scott Franklin (Republican–FL)
- Scott H. Peters (Democrat–CA)
- Scott Perry (Republican–PA)
- Sean Casten (Democrat–IL)
- Seth Magaziner (Democrat–RI)
- Seth Moulton (Democrat–MA)
- Sharice Davids (Democrat–KS)
- Sheri Biggs (Republican–SC)
- Shomari Figures (Democrat–AL)
- Shontel M. Brown (Democrat–OH)
- Shri Thanedar (Democrat–MI)
- Steny H. Hoyer (Democrat–MD)
- Stephanie I. Bice (Republican–OK)
- Stephen F. Lynch (Democrat–MA)
- Steve Cohen (Democrat–TN)
- Steve Scalise (Republican–LA)
- Steve Womack (Republican–AR)
- Steven Horsford (Democrat–NV)
- Suhas Subramanyam (Democrat–VA)
- Summer L. Lee (Democrat–PA)
- Susie Lee (Democrat–NV)
- Suzan K. DelBene (Democrat–WA)
- Suzanne Bonamici (Democrat–OR)
- Sydney Kamlager-Dove (Democrat–CA)
- Sylvia R. Garcia (Democrat–TX)
- Ted Lieu (Democrat–CA)
- Teresa Leger Fernandez (Democrat–NM)
- Terri A. Sewell (Democrat–AL)
- Thomas Massie (Republican–KY)
- Thomas P. Tiffany (Republican–WI)
- Thomas R. Suozzi (Democrat–NY)
- Tim Burchett (Republican–TN)
- Tim Moore (Republican–NC)
- Tim Walberg (Republican–MI)
- Timothy M. Kennedy (Democrat–NY)
- Tom Barrett (Republican–MI)
- Tom Cole (Republican–OK)
- Tom Emmer (Republican–MN)
- Tony Wied (Republican–WI)
- Tracey Mann (Republican–KS)
- Trent Kelly (Republican–MS)
- Troy A. Carter (Democrat–LA)
- Troy Balderson (Republican–OH)
- Troy Downing (Republican–MT)
- Troy E. Nehls (Republican–TX)
- Val T. Hoyle (Democrat–OR)
- Valerie P. Foushee (Democrat–NC)
- Vern Buchanan (Republican–FL)
- Veronica Escobar (Democrat–TX)
- Vicente Gonzalez (Democrat–TX)
- Victoria Spartz (Republican–IN)
- Vince Fong (Republican–CA)
- Virginia Foxx (Republican–NC)
- W. Gregory Steube (Republican–FL)
- Warren Davidson (Republican–OH)
- Wesley Bell (Democrat–MO)
- Wesley Hunt (Republican–TX)
- William R. Keating (Democrat–MA)
- William R. Timmons IV (Republican–SC)
- Yassamin Ansari (Democrat–AZ)
- Young Kim (Republican–CA)
- Yvette D. Clarke (Democrat–NY)
- Zachary Nunn (Republican–IA)
- Zoe Lofgren (Democrat–CA)
Nay (4)
- Eric Burlison (Republican–MO)
- Josh Brecheen (Republican–OK)
- Keith Self (Republican–TX)
- Tom McClintock (Republican–CA)
Not Voting (20)
- Andy Biggs (Republican–AZ)
- Ben Cline (Republican–VA)
- Dan Crenshaw (Republican–TX)
- Dan Newhouse (Republican–WA)
- Daniel S. Goldman (Democrat–NY)
- Frederica S. Wilson (Democrat–FL)
- H. Morgan Griffith (Republican–VA)
- Janice D. Schakowsky (Democrat–IL)
- Jared F. Golden (Democrat–ME)
- Jennifer A. Kiggans (Republican–VA)
- John J. McGuire III (Republican–VA)
- Julia Brownley (Democrat–CA)
- Lizzie Fletcher (Democrat–TX)
- Michael T. McCaul (Republican–TX)
- Monica De La Cruz (Republican–TX)
- Nancy Mace (Republican–SC)
- Neal P. Dunn (Republican–FL)
- Ralph Norman (Republican–SC)
- Robert J. Wittman (Republican–VA)
- Thomas H. Kean, Jr. (Republican–NJ)
Party labels reflect each member’s most recent affiliation on record.