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

January 5, 2026

Cost Estimate

As reported by the House Committee on Energy and Commerce on October 3, 2025

H.R. 2493, Improving Care in Rural America Reauthorization Act of 2025 As reported by the House Committee on Energy and Commerce on October 3, 2025
By Fiscal Year, Millions of Dollars		2026	2026-2030	2026-2035
Direct Spending (Outlays)		0	0	0
Revenues		0	0	0
Increase or Decrease (-) in the Deficit		0	0	0
Spending Subject to Appropriation (Outlays)		32	330	390
Increases net direct spending in any of the four consecutive 10-year periods beginning in 2036?	No	Statutory pay-as-you-go procedures apply?		No
	No	Mandate Effects
Increases on-budget deficits in any of the four consecutive 10-year periods beginning in 2036?	No	Contains intergovernmental mandate?		No
	No	Contains private-sector mandate?		No

H.R. 2493 would reauthorize the appropriation of $80 million each year from 2026 through 2030 for the Health Resources and Services Administration (HRSA) to expand delivery of health care services in rural areas, implement integrated health care networks in rural areas, and engage in activities to improve the quality of small rural health care providers. In 2025, HRSA allocated $68 million for those activities.

Based on historical spending patterns for those activities and assuming the appropriation of the authorized amounts, CBO estimates that implementing H.R. 2493 would cost $330 million over the 2026-2030 period and $60 million after 2030.

The costs of the legislation, detailed in Table 1, fall within budget function 550 (health).

Table 1. Estimated Increases in Spending Subject to Appropriation Under H.R. 2493
	By Fiscal Year, Millions of Dollars
	2026	2027	2028	2029	2030	2026-2030
Authorization	80	80	80	80	80	398
Estimated Outlays	32	66	76	78	78	330

The CBO staff contact for this estimate is YeJin Ahn. The estimate was reviewed by Chad Chirico, Director of Budget Analysis.

Phillip L. Swagel Director, Congressional Budget Office

Phillip L. Swagel

Director, Congressional Budget Office

Data and Supplemental Information

Table 1