Monday, January 06, 2014

Rural obstacles to Obamacare: few providers, lack of broadband, negative talk and misinformation

Enroll America booth (NPR photo: Eric Whitney)
Residents of some rural areas are not buying into federal health reform. They have expressed doubt and fear about Obamacare because of a lack of primary care physicians, a lack of insurance providers and hospitals, or because they don't qualify for benefits in states not expanding Medicaid. Also, Melissa Nelson-Gabriel reports for The Associated Press, many residents in conservative rural areas are being bombarded with negative viewpoints from friends, neighbors and conservative media, and fear the law based on those opinions.

That has caused problems for people like Christopher Mitchell, a marketing director for a network of nonprofit health clinics in Florida. He told Nelson-Gabriel, "I tell people that I am not here to advocate for the law, I am here to support the law and empower people to be able to use and understand the law. But when people are hearing over and over and over that is bankrupting America, it is hard to break through." The Congressional Budget Office has estimated that the law will save money by reducing health-care costs in the long run.

But it's easy for rural residents to be wary of the act, with all the hurdles they face -- long drives to doctor's offices, lack of broadband to enroll online, and the many stories about people having trouble signing up, Nelson-Gabriel writes. Kathy Bannister, a self-employed beautician, "secured a plan from Blue Cross Blue Shield of Michigan with a monthly payment of $215 after subsidies. She now pays $500 for a comparable plan from the same insurer," thanks to some outside help after several failed attempts to do it herself online, Nelson-Gabriel writes. Bannister told her "The whole idea was to make it easier for people. I'd been calling and calling and calling, and a lot of people would have given up. It's discouraging." (Read more)

UPDATE, Jan. 7: Understanding how Obamacare is working, or not working, is difficult because "We have no central clearing house" for information, writes The Washington Post's Sarah Kliff, who is doing the most consistent and comprehensive tracking of the question. She says that creates "what I like to think of as the battle of the anecdotes," which can illustrate how the law is affecting individual Americans, "but they can also be a really terrible way to gauge whether Obamacare is going great -- or is a complete disaster." (Read more)

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