The Washington machine is churning, and it wants more money from the Federal Communications Commission (FCC) for the Rural Health Care Program.

More than $400 million is earmarked for the effort now, but 31 U.S. senators want the FCC to increase that annual cap to bolster telemedicine funding for rural communities.

Advocates of telemedicine are likely over the moon at the possibility of even more federal support for the effort. They should be excited: The senators sent a letter to Ajit Pai, chairman of the FCC, requesting an expansion to meet the "current and future needs of the program."

Per a press release issued by U.S. Sen. Amy Klobuchar (D-Minn.), the effort gained steam through a "bipartisan group of 29 senators led by Senator Heidi Heitkamp (D-N.D.) in urging the Federal Communications Commission to increase the funding cap for a program aimed at improving the quality of healthcare available to patients in rural areas."

They claim the FCC needs to strengthen the rural program to address the shortage of broadband connectivity for rural healthcare providers, citing a lack of funding increases despite the growing demand for the program.

"The rural health care program has been improving the quality of healthcare available to patients in rural areas since 1997, yet the program's $400 million annual cap has remained the same for over 20 years," the senators wrote. "In 2016, for the first time ever, the demand for rural healthcare funding exceeded the cap and funding to recipients was reduced by 7.5 percent."

Funding for the current year is expected to fall short by 16 percent to 26 percent because of continued growth in demand.

"Unless the spending cap is raised appropriately to account for current needs and future growth, health care providers in rural areas will encounter severe rate increases for their broadband services, making it even harder for rural health care practitioners to engage in life-saving telemedicine," the senators roiled.

The FCC initially established the Telecommunications Program to ensure that rural hospitals and healthcare providers did not pay more for telecommunications services than their urban counterparts. Since then, however, the program has grown to include the Healthcare Connect Fund, which provides financial support to consortia that build out broadband networks to connect rural and urban healthcare providers.

According to the senators, a recent survey conducted by the Journal of Rural Health found that 59 percent of non-metro healthcare clinics have less than a 10 megabit per second connection — that’s only 1 percent of the gigabit capacity recommended by the FCC’s National Broadband Plan.

In November 2017, the FCC issued a new notice of proposed rulemaking and order, seeking comment on how to strengthen the Rural Health Care Program and improve access to telehealth services.

The American Hospital Association contends that the Rural Health Care Program must be updated to keep pace with the growing connectivity needs of healthcare providers. In February, AHA sent a letter to the FCC urging it to implement several changes, including increasing the program’s $400 million annual cap.

"The program’s full potential is limited by a spending cap that is insufficient to meet the costs associated with delivering high-capacity broadband-enabled telehealth services," according to AHA. "As the Commission evaluates the proper spending level for the RHC Program, it should strongly consider including remote patient monitoring as an eligible program expense."