Administration pitches healthcare reform's benefits for rural Americans

The healthcare reform law enacted one year ago today promises to get more rural Americans insured, improve their access to doctors and cut their medical costs, two former governors of rural states said in a newspaper editorial and during a national media conference call Wednesday.

"As former governors, we know that no matter where they chose to live, residents in rural areas need access to affordable, quality health care," Agriculture Secretary Tom Vilsack of Iowa and Health and Human Services Secretary Kathleen Sebelius of Kansas write in an editorial for the McClatchy-Tribune News Service. "Today, the Affordable Care Act is moving that vision forward. It is supporting rural caregivers and bringing new doctors and nurses to rural communities. It is holding insurers accountable. And it is giving rural Americans more affordable options for better quality coverage."

The Obama administration says the law will help reverse long-standing healthcare disparities between rural Americans and their urban counterparts. Rural Americans, according to a government report, pay more out of pocket (40 percent vs. 33 percent), have less access to primary-care physicians and specialists (half as many specialists per 100,000 people and a third the number of psychiatrists) and are more likely to defer care because of cost (15 percent vs. 13 percent).

"As people look at the way rural America was treated under the former healthcare system, and as they compare the benefits of the Affordable Care Act, I think they're going to find that there really does need to be this kind of effort in order to improve circumstances in rural America," Vilsack said during the call.

And Sebelius touted some of the law's investments for rural America. These include $11 billion for community health centers to double their capacity to 40 million patients by 2015, as well as student-loan relief and a temporary Medicare bonus for physicians who practice in rural or underserved areas.

"The Affordable Care Act will also help train and place more doctors, more nurse practitioners, more mental health specialists throughout rural America, which are often some of the more underserved areas," Sebelius said.

Despite those benefits, the law is a mixed bag for rural areas.

Many small businesses — three-fourths of all rural firms have fewer than 20 employees — say the law's tax credits are insufficient to cover their costs, which they fear will continue to grow because the law requires high-quality coverage. The law also failed to do much to tackle medical malpractice costs, which have contributed to a dearth of physicians in high-risk specialties such as obstetrics.