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4 months ago · by · 0 comments

Healthcare Reform Update: Rural Residents Under Attack in Health Insurance Proposals.


The health of people who live in rural areas is being harshly neglected in current national health policy and in healthcare legislation under discussion in Congress, according to Jeff Smedsrud, CEO of Communicating for America (CA), a non-profit rural advocacy group.

“Our government is making a habit of adopting health care legislation that forgets about the health of rural residents,” Smedsrud said.
Smedsrud, a health insurance expert and entrepreneur, said that rural Americans face numerous health disparities compared to their urban counterparts.

“According to the Centers for Disease Control, the 15 percent of the U.S. population classified as rural are more likely to die from heart disease, cancer, unintentional injury, chronic lower respiratory disease and stroke than their urban counterparts,” Smedsrud said.

He called on Congress to adjust proposed legislation to reflect the fact that rural residents tend to be older and sicker than urban residents, and that insurance choices are dwindling, and often cost more. For example, he said, in 2018 no insurers plan to provide coverage in several mostly-rural counties in Missouri, Ohio, Nevada and Washington. The entire state of Nebraska has only a single insurer under the rules of the ‘Affordable’ Care Act.

“This sparsity of coverage is a condition that needs healing right now,” Smedsrud said.
He emphasized that fewer doctors, per capita, serve rural people and quality care is often out of range physically and financially.

Smedsrud outlined a list of ten recommendations for lawmakers and federal regulators to consider as solutions to remedy the health care gap in rural America:

1.    Maintain reasonable Medicaid coverage that covers the disproportionate share of poor and elderly that reside in rural areas.

2.    Approve virtual, “tele-medicine” services for rural people under federal insurance guidelines. Make it possible for people to see a doctor or mental health provider remotely – on-screen and/or on-line – without driving long distances.

3.    Rescue rural hospitals by maintaining federal reimbursement regulations that help them stay financially viable and remain open.

4.    Recognize that the horrid national opioid epidemic is most prominent on a per capita basis in rural America, requiring funding for prevention and treatment alternatives.

5.    Ensure health insurance options and competition for rural people, so they are not trapped in a one-size-fits-all federally approved insurance plan.

6.    Allow for associations comprised of self-employed small businesses to pool their insurance buying power across state lines and negotiate rates.

7.    Enact Guaranteed Access Pools, or Unified High-Risk Pools as a safety net so all consumers with pre-existing conditions are given access to health insurance.

8.    Strengthen the rural technology infrastructure, enabling tele-medicine technologies that will narrow the rural-urban healthcare divide. Specifically, undertake an urgent program to provide high-speed internet technology to rural areas.

9.    Maintain a senior-level Rural Health Advocate in the U.S. Department of Health and Human Services with responsibility for assuring that all government healthcare decisions reflect the unique needs of rural residents.

10.  Encourage doctors to serve in rural areas with loan forgiveness programs and expedited H-1B visa processing.

Smedsrud said, “Rural America grows our food, provides important jobs and houses millions of our fellow citizens. Our country’s leaders should have the vision and courage to provide equity of health care for this population.”

Smedsrud said CA’s Platform for Rural Economic Justice provides additional information about rural health and economic issues.


Fergus Falls, Minn., July 10, 2017 –  Communicating for America (CA) advocates for the advancement of all Americans and the promotion of their general health, well-being and education . CA provides clear advice and clear answers concerning health care issues, taxes, and immigration.


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