An increasing number of people living in rural America will have far fewer options for health
insurance coverage under the Affordable Care Act (ACA) next year, according to the
Kaiser Family Foundation.
In fact, with many insurers pulling out of non-lucrative markets, consumers in regions deemed unprofitable could have only one insurer in their area participating in the ACA exchanges -- which would kill competition.
State regulators in Alaska and Alabama predict that there will be just one insurer on the ACA exchanges throughout both states. The same is predicted for some areas in Kentucky, Tennessee, Mississippi, Arizona and Oklahoma.
The Kaiser Family Foundation estimates that more than 650 counties will have only one insurer on the exchanges next year, significantly higher than the 225 counties in 2016. Of the 650 counties, 70 percent have populations that are mostly rural.
“Rural America is becoming a medical care desert in reality,” Burton Eller, National Grange legislative director, recently told Patient Daily. “Rural hospitals are consolidating. It is kind of like years ago.”
Eller said the lack of specialty doctors and cancer clinics in rural America leaves patients in need of specialty care vulnerable, with many having to travel to facilities in urban areas 30, 40 or 50 miles away in search of treatment.
“The coverage, the comparative price of many medications and treatments is up in those areas," he said. "It is basically a business -- decisions driven by business considerations, cost benefit and cost return. They bank the doctors in Minneapolis, but that doesn’t do the people in western Minnesota much good."
With choices in ACA insurance plans becoming fewer and fewer each year, Eller said the country may very well end up right where it was before the health care law was enacted.
“The people that were uninsured five years ago are going to become uninsured again; not unpredictably either -- there were folks who were saying that all along," he said. "The ACA has to be paid for by some means. When you can’t pay for it, you drop out, and the people that should be covered at a decent price are going to be uncovered again.”
Earlier this year, UnitedHealth Group, the nation’s largest health insurance company, announced its plans to exit 31 of its ACA exchanges in 34 states next year due to weak enrollment and high medical costs -- an announcement Eller said was not surprising.
“There are concerns," he said. "There are a lot of folks in rural America that were signing up and on the plan. Now the plans are leaving them, and they will be back where they were before."