Politics complicates governors' decisions on health reform, with big ramifications for rural America

Farm and Food File syndicated columnist Alan Guebert sums up why governors' decisions about expansion of Medicaid and establishment of state health-insurance exchanges are important to rural America: "We’re older, poorer and more dependent on government-supported health care than our urban counterparts. We’re also understaffed. Although nearly 25 percent of all Americans live in census-defined 'rural' areas, only 10 percent of the nation’s physicians are our neighbors."

Politics has complicated things, Guebert writes: "Early on, both choices became overtly political. Republican-led red states lined up against building 'bureaucratic' insurance exchanges and fought any expansion of Medicaid in their home pastures. Later, however, when state legislatures and governors began to examine the programs, a less political picture began to come into focus."

Guebert cites a Harvard University School of Public Health study concluding that for every 176 adults added to Medicaid, one life was saved, and the estimate by Dr. Wayne Myers, former director of the federal Office of Rural Health Policy, that expansion of Medicaid in all states would save 80,000 lives a year at a price of about $10,000 each.

"Ten grand is chicken feed if you or a family member becomes sick. Yet, the political leaders in 30 mostly rural states either stand undecided or decidedly against expanding Medicaid to their citizens," Guebert writes. "Why? It can’t be money, because the ACA is the law and Medicaid is almost certain to be expanded with or without these states taking the -- duh -- 93 percent federal cost-sharing offer on the table. That leaves politics or religion as the reason, so ask your local politicians which it is. And while you’re at it, ask those political leaders what kind of taxpayer-supported health care insurance they have." (Read more)