Health insurers' adaptation to Obamacare has widened the cost gap between rural and urban areas

"Health care has always been more expensive in far-flung communities, where actuarial insurance data show fewer doctors, specialists and hospitals, as well as older residents in need of more health care services. But the rural-urban cost divide has been exacerbated by the Affordable Care Act," reports Kristen Wyatt of The Associated Press.

Western Colorado rancher Bill Fales told Wyatt, "We've gone from letting the insurance companies use a pre-existing medical condition to jack up rates to having a pre-existing ZIP code being the reason health insurance is unaffordable." Wyatt notes, "Geography is one of only three determinants insurance companies are allowed to use to set premiums under the federal health care law, along with age and tobacco use. Insurance officials say they need such controls to remain viable." (Read more)

The Rural Blog has previously reported on the rural problem, caused in part by insurance companies' unwillingness to sell policies in certain areas, resulting in a lack of competition and rates that would otherwise be lower. Also, states that did not embrace the health reform law do not have non-profit insurance cooperatives, which must offer policies statewide, and for-profit insurers are avoiding poor areas, which are disproportionately rural.