Rural Americans More Likely to Be Uninsured and Underinsured - Center for Rural Affairs unveils rural health care report at White House meeting

Release Date: 



John Crabtree,, Center for Rural Affairs, (563) 581-286 or, Jon Bailey,, Center for Rural Affairs, (402) 687-2100
Washington, DC - Jon Bailey, Center for Rural Affairs Research Director, presented the report Causes And Consequences of the Rural Uninsured and Underinsured at a White House meeting between rural health care stakeholders and Administration officials this morning. Bailey discussed the Center's most recent report on rural America's health care system and rural health care challenges with Nancy-Anne DeParle, Director of the White House Office of Health Reform, Dr. Mary Wakefield, Administrator, Health Resources and Services Administration, and Tina Tchen, Director, White House Office of Public Liaison.
Bailey, who traveled from Nebraska to attend the meeting at the behest of the White House, said, "It is encouraging that the White House is paying attention to the unique challenges rural America faces in the health care reform debate.  And our report on the rural uninsured and underinsured provides ample evidence of the importance of health care reform and a public health insurance option to rural America."

For a link to the video of the discussion and more information about the White House forum visit:

According to the report, rural Americans are more likely to be uninsured or underinsured than urban Americans. With an economic foundation of small businesses, self-employment, and low wage work, rural communities are not well served by a health insurance system that relies on employer-based coverage. Many more rural families are forced to purchase from the individual insurance market where they all too often wind up underinsured, with coverage that costs too much and provides too little. Those who cannot afford the significantly more expensive individual insurance packages must go without or rely on public insurance.

The report found:

  • Rural residents were found to be twice as likely to be underinsured as urban residents
  • 8% of the general population depends on individual policies with reduced benefits and high deductibles, but 33% of farmers and ranchers rely on such policies
  • 25% of non-corporate farms and ranches carry medical debt and 25% of that number report that medical expense "contribute to their financial problems"
  • Approximately 50% of rural employees work for small businesses, as compared to 37% of urban employees, and small business employees are twice as likely to be uninsured

The full report is available online at:

"Unfortunately, these circumstances conspire to weaken rural communities.  A rural community's economic development, social cohesiveness and health care infrastructure are all threatened by a lack of affordable health insurance that results in more families without health insurance or with less than adequate insurance," Bailey explained.

"And we all pay for the skyrocketing costs of health insurance.  Like most issues facing rural America, everyone is in this together. That is why it is so crucial for reform legislation to create a public health insurance option that provides rural small business and the rural self-employed the ability to choose more affordable, quality health care coverage," added Bailey.
The release of the report comes just as the Center concludes hosting health care forums across the Midwest. The forums, attended by health care practitioners, farmers, ranchers, workers, teachers, students, retirees and elected officials, discussed how health care reform will impact rural small business, family farmers, ranchers and rural communities.

At the White House meeting Bailey also discussed the findings of two previous Center for Rural Affairs reports on health care reform and rural America.

    -  Top Ten Rural Issues for Health Care Reform -

    -  Nutrition, Physical Activity, and Obesity in Rural America -

Additional reports exploring a variety of rural health care issues - including policy issues, and how congressional reform proposals address rural health care, will be released in the coming weeks. As they are released, these papers can be found at the Rural Health Care Reform section of the Center for Rural Affairs' website,

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