But others in the far eastern town of Pikeville, from which Campo-Flores reported, indicated positive interest in the state health benefits exchange, Kynect, that will go online Oct. 1 with standard policies with subsidies for most people, or a Medicaid program being expanded by Democratic Gov. Steve Beshear, at 100 percent federal expense for the first three years, 90 percent by 2020.
Rural signups are critical in states like Kentucky, where 45 percent of the estimated 640,000 uninsured people live outside metropolitan areas. Nationally, only 17 percent of the uninsured are rural, Campo-Flores notes.
"Cara Stewart, a health-law fellow at the not-for-profit Kentucky Equal Justice Center, has been driving 6,000 miles a month traversing the state to reach residents," Campo-Flores reports. "She said she has enlisted local pastors and choir leaders to help connect her with their congregations. Another avenue she is pursuing: the Cooperative Extension Service offices of Kentucky’s two land-grant universities." Stewart said, “They’re a neutral, trusted source of information.” (Read more)
University of Kentucky Extension Service Director Jimmy Henning said in an email to The Rural Blog, "We are doing a lot of education relating to health, just as we always have done, and that would include helping people evaluate their options" under the reform law, but agents are not acting as paid navigators. That's in keeping with their roles as independent providers of information. Henning said, "The ‘fit’ for Extension relative to it being a health navigator varies by state, depending on who is administering the health exchange and setting up the conditions for the grant."
In North Carolina, which has a large rural population, "There are few details about how uninsured people in some of the state's least healthy counties will receive help navigating the system," reports Justin Smith of WECT-TV in Wilmington. In Republican-controlled North Carolina, the federal government is running the exchange and Medicaid is not being expanded.
None of the 14 non-profits that the federal goverment is using to help people navigate the new system is "based in the southeastern part of the state," Smith reports. "Most of the organizations serve other parts of the state or specific populations, like people with disabilities or substance abusers. The only organization that appears to have a physical presence in the region is Legal Aid of North Carolina, which has an office in downtown Wilmington." (Read more)