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119th Congress Health

H.R. 2493: Improving Care in Rural America Reauthorization Act of 2025

Passed HouseApr 21, 2026

  1. Introduced (completed)Mar 31, 2025
  2. Passed House (completed)Apr 21, 2026, 406–4
  3. Passed Senate (not reached)
  4. To the President (not reached)
  5. Became law (not reached)

Summary

Introduced in House, Mar 31, 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.
Read the full summary

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.

Written by the Congressional Research Service, Library of Congress.

Key votes

House final vote, Apr 21, 2026

On Motion to Suspend the Rules and Pass

Passed 406–4

Yea 406two-thirds 274Nay 4

  • Democrats207 yea, 0 nay
  • Republicans198 yea, 4 nay
  • Independents1 yea, 0 nay

Broke with their party: Keith Self (R-TX), Tom McClintock (R-CA), Josh Brecheen (R-OK) and Eric Burlison (R-MO) voted Nay

See how all 410 members voted

Showing 430 of 430 members

Yea 406

Republicans (198)

Democrats (207)

Independents (1)

Nay 4

Republicans (4) broke with their party

Not voting 20

Senate

Not yet voted

Passed the House Apr 21, 2026. Awaiting Senate action.

Roll calls

1 vote on this bill

Showing 1 of 1 roll calls

  • Apr 21, 2026HouseOn Motion to Suspend the Rules and PassFinal passagePassed, yea-nay 406–4
    Roll call 128 tally by party
    PartyYeaNayPresentNot voting
    Democrats207006
    Republicans1984014
    Independents1000
    Total4064020

    House roll call 128: On Motion to Suspend the Rules and Pass. Passed.

    4 crossed party lines: 4 Republicans

    How each member voted (430)

Amendments

0 offered

No amendments were offered to this bill.

Cosponsors

5

Bipartisan support.

Who scored on this bill

112 points earned
  1. 1Earl Carter R-GA SponsorDrew cross-party cosponsors, introduced, marked up, reported, passed House5 events+68
  2. 2Josh Brecheen R-OK1 maverick vote1 event+6
  3. 2Eric Burlison R-MO1 maverick vote1 event+6
  4. 2Tom McClintock R-CA1 maverick vote1 event+6
  5. 2Keith Self R-TX1 maverick vote1 event+6
See all scorers and every scoring event

Introductions and cosponsorships count toward weekly caps and show no points.

Other bills by Earl Carter

History

  1. Apr 21, 2026Passed the House, 406–4.
  2. Mar 31, 2025Introduced in the House by Earl Carter.
Show the full action history (18 actions)
  1. Apr 22, 2026Received in the Senate. Read twice. Placed on Senate Legislative Calendar under General Orders. Calendar No. 377.
  2. Apr 21, 2026Mrs. Harshbarger moved to suspend the rules and pass the bill.
  3. Apr 21, 2026Considered under suspension of the rules. (consideration: CR H3021-3023)
  4. Apr 21, 2026DEBATE - The House proceeded with forty minutes of debate on H.R. 2493.
  5. Apr 21, 2026At the conclusion of debate, the Yeas and Nays were demanded and ordered. Pursuant to the provisions of clause 8, rule XX, the Chair announced that further proceedings on the motion would be postponed.
  6. Apr 21, 2026Considered as unfinished business. (text: CR H3025)
  7. Apr 21, 2026Passed/agreed to in House: On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 406 - 4 (Roll no. 128). (text: CR H3021-3022)
  8. Apr 21, 2026On motion to suspend the rules and pass the bill Agreed to by the Yeas and Nays: (2/3 required): 406 - 4 (Roll no. 128). (text: CR H3021-3022)
  9. Apr 21, 2026Motion to reconsider laid on the table Agreed to without objection.
  10. Oct 3, 2025Reported by the Committee on Energy and Commerce. H. Rept. 119-325.
  11. Oct 3, 2025Placed on the Union Calendar, Calendar No. 278.
  12. Sep 17, 2025Committee Consideration and Mark-up Session Held
  13. Sep 17, 2025Ordered to be Reported by the Yeas and Nays: 49 - 0.
  14. Sep 10, 2025Referred to the Subcommittee on Health.
  15. Sep 10, 2025Subcommittee Consideration and Mark-up Session Held
  16. Sep 10, 2025Forwarded by Subcommittee to Full Committee by Voice Vote.
  17. Mar 31, 2025Introduced in House
  18. Mar 31, 2025Referred to the House Committee on Energy and Commerce.