Rural America presents a unique set of challenges for health care reform. Rural people have less access to health networks and health care providers, greater rates of disability and chronic diseases, and higher use rates of all public health care programs. And largely as a result of higher rates of self-employment and small business employment, rural Americans have lower rates of employer-provided benefits and are more likely to be underinsured or uninsured for longer periods of time. The 60 million people in rural America are most in need of health care system reform and have much to contribute to any reform debate.

Health care is also a major barrier to rural economic development that creates genuine opportunity and reduces poverty. Microenterprise and small business development is the most effective path in many communities for low and moderate-income rural people to pull themselves out of poverty. But if small entrepreneurs cannot gain affordable access to health care for themselves or their employees, that path out of poverty is blocked. Any hope of building genuine economic opportunity for struggling rural Americans through entrepreneurship must be accompanied by reforming the health care system in a way that benefits both small business owners and their employees.

It is vital that the unique health reform challenges of rural areas are carefully articulated to policymakers. Reform can either address these unique challenges and provide an opportunity for healthier people and more sustainable communities, or exacerbate the current situation.

The Center for Rural Affairs has always believed that guiding principles are fundamental to any public policy effort. Our work on health care is no exception. Any proposed health care solution or reform should be:

• Universal, which includes a choice of a private insurance plan, including keeping the insurance you have if you like it, or a public insurance plan that guarantees affordable coverage.
• Continuous.
• Affordable to individuals and families.
• Affordable and sustainable for society.
• Enhance health and well-being.

We are writing a series of papers on unique and critical rural issues that must be addressed in the health care reform debate. The first, Nutrition, Physical Activity and Obesity in Rural America, highlighted current research and statistics on the health status of rural America, detailed the long-term consequences for rural people and communities, and outlined a set of solutions, policy and otherwise.

We are organizing rural people in Iowa, Montana, North Dakota and western Wisconsin, all crucial areas to the health care reform debate, to provide them opportunities to discuss with their policymakers health care and solutions that will benefit rural people and communities.

The health care reform debate promises to be long. Check our website at http://www.cfra.org/policy/health-care for the latest news, publications and opportunities to contribute. You can also stand up for health care reform that works for everyone, including rural people, family farmers and small business owners by signing our petition at http://www.cfra.org/policy/health-care/advocacy. We will share your signatures and your comments with the Obama administration.

Contact: Jon Bailey, jonb@cfra.org or 402.687.2103 x 1013 for more information.