ACA improved coverage, care access for rural Americans

Farm scene with mountains in the background

The Affordable Care Act “dramatically” improved health coverage for those living in rural America and provided this population with better access to care, according to a new report from the Department of Health and Human Services.

Overall, the Obama administration has said, the ACA led 20 million U.S. adults to gain coverage from 2010 to early 2016.

For those who live in rural counties, HHS says its new analysis found coverage increased by 8 percentage points between late 2013 and early 2015. This coverage gain, the report notes, is on par with that experienced by residents in the suburbs and in cities, even though rural Americans are disproportionately likely to live in states that have not expanded Medicaid.

Rural communities could benefit even more if the remaining 19 states chose to expand Medicaid, HHS points out--a goal the Obama administration has long pushed for.

Yet already rural Americans are benefitting from the ACA’s elimination of coverage exclusions based on pre-existing conditions, the creation of the health insurance marketplaces and cost-sharing subsidies, the report notes. Those living in rural areas comprise nearly 1 in 5 plan selections on Healthcare.gov in 2016, and 88 percent of rural consumers are eligible for premium tax credits.

Like their suburban and urban counterparts, rural Americans’ access to care also increased once the ACA’s main provisions took effect. The share without access to a personal physician dropped 3.4 percentage points, and the proportion of those unable to afford needed care dropped 5.9 percentage points, HHS says.

Individuals living in rural areas still face barriers, however, as some rural providers struggle to adapt to value-based business models. In fact, some rural hospitals are being forced to close their labor and delivery units, restricting women’s access to care.

To learn more:
- download the HHS report
- here’s the announcement