The health of rural America is failing, and a repeal of the Affordable Care Act (ACA) without adequate replacement could prove disastrous. A December, 2016 report from the Centers for Disease Control and Prevention showed that for the first time in 20 years, life expectancy in the United States has declined, particularly in small cities and rural areas, where people are dying at much higher rates. This shocking trend is driven in part by increasing mortality rates for white, working-class Americans, many of whom live in rural America.
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Taken as a whole, Medicaid expansion through the ACA has resulted in critical gains toward improving rural population health by expanding insurance coverage and stabilizing rural hospitals.
The repeal of Medicaid expansion and collapse of the individual insurance market, which could occur as part of repeal of the ACA, could threaten strides the country has made in advancing the health of rural America.
It is no surprise that rural Americans experienced the highest rates of coverage gains through the ACA. They have been more likely to have had inadequate access to affordable health care for years. This dramatic increase in insurance is translating into improved health for these communities.
For example, in Arkansas and Kentucky, Medicaid expansion resulted in fewer people skipping medications due to cost, a decline in difficulty paying medical bills and an increase in regular doctor visits for chronic illnesses.
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