Since the Patient Protection and Affordable Care Act started requiring Americans to have health insurance a few years ago, millions of people who'd never had such coverage have been able to obtain it. Interestingly, though, one of the biggest areas of impact for this expanded coverage in that relatively short period of time is in rural America.
Between late 2013 - when the open enrollment window for the ACA's exchanges first opened - and the start of last year, the rate at which consumers living in rural U.S. counties had health insurance increased 8 percentage points, according to a new study by the U.S. Department of Health and Human Services. That's more or less in line with the rate seen in urban areas, where the increase came to 7.9 percent over the same period.
A closer look at the numbers
But what's interesting here is that these changes for rural Americans came despite the fact that they tend to live in states which chose not to expand their Medicaid programs, while those with larger urban centers did, the report said. In all, about 2 in every 3 people living in rural areas fall into the former category, compared with slightly more than half of those in the latter.
Consequently, the gains being made for rural counties could reasonably be said to mostly come from ACA exchange sign-ups. Further, the growing number of people with health insurance brought the number of people who say they can't afford to get regular health care down 6 percent.
"The Affordable Care Act has helped millions of people in rural areas access quality, affordable health coverage," said Sylvia Burwell, U.S. Secretary of Health and Human Services. "As someone from rural America, I know how important these gains in coverage and access to care are to communities like my hometown of Hinton, West Virginia."
Not included in those statistics, though, is the fact that even more people bought coverage for 2016, the report said. In all, about 1.7 million people living in these areas purchased policies for this year, up 11 percent from 2015, outpacing the growth rate for the exchanges overall. Indeed, rural Americans now make up about 20 percent of all people enrolled in coverage purchased on the marketplaces. In addition, for close to 90 percent of all people who signed up and were eligible for tax credits, the average increase in costs for this year's premiums was only about 4 percent - or $5 a month.
Anecdotal evidence is beginning to suggest that some states that had previously refused to expand Medicaid may be softening on the idea these days, but whether that happens remains to be seen. As a result, the federal government and health insurance companies themselves may want to take the time to do more outreach and let people living in these areas know what their options for finding affordable coverage may be. In doing so, they can help those people stay compliant with federal law and also gain more access to low-cost care when they need it.