Health Insurance Exchanges that Work for Rural

The Center for Rural Affairs released a report on the one year anniversary of President Obama signing the Affordable Care Act. Entitled, Health Insurance Exchanges that Work for Rural (to download the report see: http://files.cfra.org/pdf/Health-Insurance-Exchanges.pdf ), the report examines how rural Americans will benefit from the primary feature of the Act, health insurance Exchanges - competitive health insurance marketplaces that provide quality, affordable health coverage for individuals and small businesses.
The Affordable Care Act allows states to develop two health insurance marketplaces by January 2014, one for individuals and one for small businesses with up to 100 employees.  The Act also provides funds to cover planning, implementation and operating costs until 2015.  If states fail to establish exchanges, Health and Human Services will create one for them.

Lower population density will lead insurers to charge higher and ultimately unaffordable rates for rural residents. To avoid this, rating areas in health insurance markets should be at least statewide.  Rural areas have more small businesses and more self-employed residents.  Small business workers are more likely to be uninsured due to high costs in small risk pools. Therefore, health insurance marketplaces must be attractive to small employers to be successful on our rural mainstreets.

Considering these unique rural challenges requires that states listen. Governing and advisory boards for health insurance marketplaces should include serious rural representation. States should do aggressive outreach to farmers, ranchers and small town residents. After all, the key to making reform work is empowering consumers with information.