A growing problem in rural America is the growing distances its citizens must travel for health care, thanks to years of hospital and clinic closures as large companies buy and consolidate facilities in rural areas. But also because insurance companies don’t include nearby facilities in their networks. And federal regulators are institutionalizing this trend.
Carol Miller, a community organizer in New Mexico, comprehensively writes about this issue in The Daily Yonder, focusing on the chart below showing how federal regulators propose to allow insurers to discriminate against rural populations and still participate in the markets set up by the Affordable Care Act.
One of the worst things about this table is that it exists and is in the public realm. I am extremely concerned that it might dangerously take on a life of its own. Remember, that just as the Health Professions Shortage Area designation was originally created for use by a single program, there are now are more than 20 programs using it. The standards proposed in this table need to go away and never be used by any program. The goal needs to be access to care for people living in rural and CEAC communities [counties with a population density of less than 10 per square mile], not distances and travel times that will guarantee not only worse access, but also worse health.
source: Centers for Medicare and Medicaid Services, Dept. of Health and Human Services
