Obamacare Leaves Rural America Behind

Posted on December 27, 2013


So far, rural Americans have been decidedly cold-shouldered by the Affordable Care Act (ACA). The president’s signature piece of legislation precludes residents of the nation’s less populated counties, offering few options and almost none that are affordable.

USA Today reports,

More than half of the counties in 34 states using the federal health insurance exchange lack even a bronze plan that’s affordable — by the government’s own definition — for 40-year-old couples who make just a little too much for financial assistance, a USA TODAY analysis shows.

Many of these counties are in rural, less populous areas that already had limited choice and pricey plans, but many others are heavily populated, such as Bergen County, N.J., and Philadelphia and Milwaukee counties.

More than a third don’t offer an affordable plan in the four tiers of coverage known as bronze, silver, gold or platinum for people buying individual plans who are 50 or older and ineligible for subsidies.

This reality stands in stark contrast to earlier statements made by the U.S. Department of Health & Human Services. In a so-called Fact Sheet entitled “The Affordable Healthcare Act- What it Means for Rural America”, HHS promised that Obamacare would provide affordable coverage plans and increased access and control, while eliminating healthcare inequality.

The White House also released a document titled “Health Reform For Rural Americans”, stating that Obamacare would provide increased choices due to amplified competition, driving prices down while beefing up the quality of health care plans.

So far, these promises are not coming through. The New York Times reports that competition has not increased because the Affordable Care Act failed to account for factors that influence competition.

The analysis suggests that the ambitions of the Affordable Care Act to increase competition have unfolded unevenly, at least in the early going, and have not addressed many of the factors that contribute to high prices. Insurance companies are reluctant to enter challenging new markets, experts say, because medical costs are high, dominant insurers are difficult to unseat, and powerful hospital systems resist efforts to lower rates.

Plenty of ink has been spilled regarding the initial rollout of Obamacare and the healthcare website. For many families, however, the difficulties with the healthcare bill may far outlast its implementation. If the website ever gets up and running, rural Americans will still find themselves excluded by the structure of the bill itself.

Posted in: Healthcare, Politics