OPINION:
I’ve spent most of my life on the front lines of healthcare in East Tennessee first as a community pharmacist for over 30 years, and now as a member of Congress serving one of the most rural districts in the country.
I’ve filled prescriptions for diabetics struggling to afford insulin. I’ve counseled patients managing heart disease on a fixed income. And I’ve watched too many neighbors delay care, not because they didn’t want help, but because getting it meant an hour-long drive over mountain roads to see a specialist who may not even be accepting new patients.
Rural Americans don’t need to be shown data to understand healthcare disparities. They live them every day.
What we need is a serious commitment to prevention not just treating disease after it takes hold but getting ahead of it as well. That’s the heart of the Make America Healthy Again (MAHA) agenda that U.S. Secretary of Health and Human Services Robert F. Kennedy and the Trump administration are advancing, and it’s exactly what I’m fighting for in Congress as a proud member of the House MAHA Caucus.
Obesity, diabetes, heart disease and hypertension are ravaging communities across rural America at rates that outpace many urban areas. Diet-related chronic disease does not just shorten lives. It breaks family budgets, strains rural hospitals already operating on razor-thin margins and drives up costs across the entire healthcare system.
Every dollar we fail to invest in prevention costs us far more downstream in hospitalizations, emergency care and long-term disease management.
Here’s the good news: we already have a trusted, proven infrastructure to deliver prevention at scale. Federally qualified health centers serve more than 32 million patients at over 16,000 sites nationwide, including one in five rural residents. Patients know and trust them. And in places like East Tennessee, where getting to a specialist can feel like an expedition, the local health center may be the most accessible primary care a family has.
But today, only about 25% of these centers provide meaningful nutrition services. That gap is costing us in health outcomes, taxpayer dollars and lives.
That’s why I introduced the Nutrition Education and Chronic Disease Prevention in Community Health Centers Act, legislation to integrate evidence-based nutrition counseling directly into primary care delivery at federally qualified health centers nationwide. My bill supports provider training in nutrition science, strengthen team-based care models that include registered dietitians and community health workers, and prioritize health centers serving communities with the highest rates of food insecurity and diet-related disease.
The timing is right. Earlier this spring, just one week before a House Energy and Commerce Health Subcommittee hearing, the Trump administration’s Health Resources and Services Administration (HRSA) announced more than $135 million in new funding to expand nutrition services and strengthen the rural health workforce a strong signal that Washington is finally taking prevention seriously.
My legislation builds on that momentum by creating a durable, scalable framework to help community health centers bring nutrition services into everyday primary care.
At our hearing, I asked Jamie Ulmer, President and CEO of Healthcare Network, what integrating nutrition services into primary care has already done, and what it has the potential to do. His answer was straightforward: chronic disease rates go down, emergency room visits go down, patients get healthier and families learn things they did not know they did not know.
That’s not a complicated public policy theory. That’s what happens when we treat the cause instead of waiting to treat the consequence.
As a pharmacist, I’ve always believed that the best prescription is the one you never have to write. But making that possible in rural America means meeting people where they are: in the community health centers they already rely on, with services that actually reach them.
I’m grateful for Secretary Kennedy’s leadership on this front. The MAHA agenda’s focus on prevention, addressing the root causes of disease, and empowering Americans to live healthier lives is the right direction for this country. And for rural America especially, it couldn’t come at a more critical time.
For more than 30 years, I stood behind a pharmacy counter in East Tennessee and saw what happens when prevention fails. I filled the prescriptions. I saw the diagnoses. I watched manageable conditions become life-altering ones because nobody caught them early enough.
We can do better. And with the right investment in community health centers, we will.
• Rep. Diana Harshbarger represents Tennessee’s First Congressional District. She serves as Vice Chair of the House Energy and Commerce Subcommittee on Health and Co-Chair of the Congressional Bipartisan Rural Health Caucus. A licensed community pharmacist for more than 30 years in East Tennessee, she is a member of the House MAHA Caucus.
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