28 rural Nebraska counties center of health care debate

Rural Nebraska has taken its place in the national health care debate.

In the weeks leading up to the anticipated vote on the American Health Care Act, rural Nebraska personified the millions of older rural adults who shouldered much of the cost shift of the proposed plan.

Under the proposed legislation, in 28 rural Nebraska counties, those aged 60 and older and earning less than $30,000 would have seen out of pocket premiums rise by more than $1,500 per month. This increase would be cost prohibitive for low-income older rural adults and inhibit their ability to purchase sufficient coverage to meet preventative and maintenance care needs. Many would simply forgo coverage.

Despite the withdrawal of the vote on the American Health Care Act and the indefinite postponement of further discussion, health care access remains a challenge. For rural residents, the stakes are high. On average, people in rural counties tend to be older, have lower incomes and have less choice when it comes to providers and insurers.

As the conversation regarding replacement of the Affordable Care Act dissipates, the need to address the current challenges of rural health care access remains. Staffing shortages, insufficient mental health services and the costs of caring for an aging population all stand as limitations to care. Additionally, insurance is a mirage for thousands who remain in the coverage gap due to Nebraska’s decision not to expand Medicaid coverage.

Before the realities of rural health care fade from view, let’s not forget the challenges and opportunities that remain for rural health care access, and the individuals whose lives depend on it. It’s time to expand Medicaid in Nebraska.