Rural states with most to gain from health reform tend to have senators under fire from vocal foes

Some of the most vociferous opponents to reforms that could bring insurance to many employed rural Americans are those same rural Americans, reports James Oliphant of the Los Angeles Times. But Bill Bishop and Julie Ardery of the Daily Yonder take issue with the Times story, writing that "The relationships among geography, politics and health insurance aren’t so divisive and extremist as the Times and the TV screens would suggest."

Oliphant writes that senators from rural states with higher percentages of uninsured workers have been some of the most eager to work toward a health-care compromise, but those senators have faced vocal opposition from constituents.

A high percentage of employers across rural America are small businesses that don't offer health insurance, Oliphant reports. Western and Southern states also have lower incomes than other parts of the country but higher thresholds for Medicaid eligibility, leaving employed people without coverage. "The states that tend to be more conservative have a higher rate of people who are uninsured," Ron Pollack, director of pro-reform Families USA, tells Oliphant. "As a result, health-care reform is going to provide a disproportionate amount of resources to those states."

Bishop and Ardery note that a recent report on health-care coverage from the U. S. Census Bureau shows the counties with the lowest percentages of uninsured residents are overwhelmingly urban. Rural counties with the largest number of uninsured voted in a landslide for Sen. John McCain in the 2008 election, and the "national press has, for the most part, missed the facts and the variations in health insurance rates across rural America." (Read more)

Not all the public outcry in rural areas has been directed at health care reform, Jack Hatch, a Democratic state senator in Iowa, tells Oliphant. "I've been to a half a dozen of these [town hall meetings]," Hatch said. "There are maybe 15 to 20 percent of the people who are just angry with everything. They're angry with their economic situation. When we shift to health care, there's a lot less noise and a lot more questions." (Read more)