Rural America and Health Care Reform

Rural Americans face unique challenges in our current health care system. When Congress acts on health care reform later this summer, their legislation will need to address rural concerns if Congress hopes to fulfill the promise of making the health care system fair and equitable to all.

For rural America, health care reform is crucial to rural economic revitalization and the creation of economic opportunity. The rural economy is based on self-employment and small business development to a far greater extent than in urban centers. Owner-operated farms, ranches and small businesses dominate the rural economy. As a result, rural people are more often under-insured, more dependent on the individual insurance market and pay more for less coverage.

As health insurance premiums and out-of-pocket medical expenses rise, more small businesses drop unaffordable coverage for themselves and their employees. This threatens the well being and quality of life of rural residents, as well as the economic vitality of their communities. Rural economic development efforts are hampered by the risk that entrepreneurs face in leaving employment with health care benefits to start up their own business, forcing them to navigate the turbulent market for individual health care coverage.

Congress must craft legislation that provides additional, equitable options to small business and the self-employed for comprehensive, affordable coverage. You can find out more and sign the Center for Rural Affairs’ health care reform petition at

To share your own health care story or get involved in the Center’s health care work, contact Virginia Wolking at or 402.687.2100.