The ACA "was intended to slash the number of uninsured patients seeking care they could never afford at hospitals," reports AP. "It succeeded in rural areas, where overall the rate of uninsured people fell by 8 percent since full implementation of the law in 2014, said Brock Slabach, of the National Rural Health Association. But it fell more in urban areas, in part because of the dearth of choices in the exchanges set up under the ACA. Thirty to 40 percent of rural communities have only one company from which to pick" if they want to buy private insurance.
"Now, as Republicans in Washington put forward long-anticipated plans to get rid of ACA, rural hospitals and communities are watching the debate closely," reports AP. "But if they didn't fare too well under the ACA, many question whether they'd be better off under the plan backed by President Donald Trump."
Also, hospital "administrators say they haven't heard much in the proposal that sounds beneficial—besides perhaps the chance to allow Americans to shop for insurance across state lines," AP reports.