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Obamacare Leaving Rural America Behind


The Affordable Care Act’s benefits, such as they are, may come at the expense of the rural working class. The New York Times reports that the lack of competition in rural exchanges will dramatically drive up prices for many Americans:

While competition is intense in many populous regions, rural areas and small towns have far fewer carriers offering plans in the law’s online exchanges. Those places, many of them poor, are being asked to choose from some of the highest-priced plans in the 34 states where the federal government is running the health insurance marketplaces, a review by The New York Times has found.

Of the roughly 2,500 counties served by the federal exchanges, more than half, or 58 percent, have plans offered by just one or two insurance carriers, according to an analysis by The Times of county-level data provided by the Department of Health and Human Services. In about 530 counties, only a single insurer is participating.

Even liberal media outlets that strongly backed Obamacare are coming out with new stories every day about the glitches and unintended side effects of this poorly drafted law. In light of that, it seems increasingly likely that the building wave of failures will ultimately force the administration back to Congress to try to tidy up this mess. What’s not yet clear is whether the changes will be big or small, reform-based or repeal-based. The next few months will be play a large role in determining the direction of that conversation.

Whatever direction the tidying up takes, however, reformers should bear in mind that this story also points to the sinking fortunes of working class rural America. With stagnating wages and tumbling life expectancies, rural Americans are falling even farther behind their urban counterparts. This story confirms that the trend holds in health care as well. We are moving, as our colleague Adam Garfinkle has noted, to an even more class-stratified health care system.

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  • rheddles

    They didn’t vote for him. And their dead people don’t usually vote. Chicago rules.

    • Corlyss

      We are such shameful cynics . . .

  • Corlyss

    “Obamacare Leaving Rural America Behind”

    How could it leave behind something that was never on board? Health care delivery to rural America was the subject of the 90’s sitcom Northern Exposure. It was bad then. It’s worse now. It’s going to get even more so with the pending Obamacare-produced doctor shortage. They can’t even sing the refrain from Big Yellow Taxi because they never had it to lose in the first place.

  • USNK2

    Rural Americans, even in deep Blue states, are being left behind because that 2009 Stimulus that included high speed internet access is still in progress (snail’s pace), and rural towns and villages are more dependent on the USPS. Home values are dropping.

    The general problem with Obamacare seems to be the mandated specifics that have to be covered, regardless of whether the consumer of the insurance policy needs the mandated covberage.

    Some states are so rural the population pool is probably not big enough to entice insurers to participate.

    The regulation of insurance companies by each state is an interesting hurdle to overcome without somehow making things worse.

  • ljgude

    I grew up in rural America and all I can say is: “But of course.” It has been a long time since the rural working classes have been a significant voting block as WRM has pointed out a time or two. Given that the NY Times is mouthpiece of the Blue Establishment I would say this story is deliberately putting the focus on a minor unintended consequence of a disastrously written bill. So far all we have seen is monster unintended consequences and it still quite possible that is all we will ever see.

  • free_agent

    Perhaps this observation is related to the fact that rural America is the base of the Tea Party and the Tea Party detests Obamacare.

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