The Senate’s current draft of the Better Care Reconciliation Act, the plan to repeal the Affordable Care Act, strikes directly at the vulnerabilities of health care in rural America. For rural populations that tend to be older, poorer, and have more health concerns, this plan would implement even greater barriers to health care access.
Paying more for less does not make sense when buying cereal or laundry soap at the grocery store and it certainly does not make sense make sense when purchasing health insurance. Yet this is exactly what the Senate’s bill proposes. For rural residents who were able to gain health care coverage because of the Affordable Care Act, this bill would only allow them to purchase lesser plans with much higher deductibles, meaning more out of pocket costs.
In addition to increased deductibles, coverage of essential benefits may no longer be required. Under the proposed plan, states would be able to apply for waivers to cut the coverage of basic health benefits like mental health care, rehabilitative services, or prescription drug coverage, resulting in added out of pocket costs even for those with insurance. In rural areas that are already facing provider shortages and greater travel distances for patients, returning to a system where these basic health services come with added costs only exacerbates the inequities of rural health.
The proposed cuts of $772 billion in federal Medicaid spending over the next 10 years will have a particularly negative impact upon rural communities. Currently, Medicaid covers 16 percent of adults and 45 percent of children in small towns and rural areas. A cut of this magnitude will negatively impact children, older adults, and people with disabilities who depend on Medicaid for access to care.
Just because Medicaid funding goes away does not mean that the health challenges facing rural populations will do the same. People will still need medical care, and hospitals and clinics will attempt to find ways to provide care without reimbursement, but ultimately, all rural residents who rely on hospital services for care will suffer.
Despite its shortcomings, the Affordable Care Act has helped to close the health disparities gap in rural America. The Senate’s plan erases the advances to rural health that have been made over the last five years, and instead places the health of rural residents on an backwards trajectory. Rather than pausing to consider minor changes to the Senate’s bill over a long holiday recess, leaders need to continue to work toward a solution that moves health care forward for all Americans.
Protect your health care and contact your senators today.
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