How the Obamacare insurance marketplace can help rural residents

Oct 9, 2013

Credit Alan Cleaver / flickr

The Affordable Care Act’s online insurance marketplace has its problems, but the service also has potential to help improve rural health. Jon M. Bailey, the director of rural research and analysis at the Center for Rural Affairs, went as far as putting it this way:

“The new health insurance marketplaces were practically created for rural people.”

Here’s why: The marketplace is targeted to help the uninsured and underinsured population, and those who don’t have access to employer-sponsored insurance plans. As Bailey pointed out to me, that target group exist in larger concentrations rural areas.

In Missouri, counties that have higher percentages of uninsured residents tend to be rural. And because the rural economy is largely propped up by self-employment and small-business ownership, rural residents have less access to employer-sponsored insurance. They have to depend on the individual insurance market.  

“When people buy health insurance on their own on the individual market it’s usually more expensive and doesn’t cover as much,” Bailey said. “A lot of statistics show rural people get fewer check-ups and tests that would show diseases at earlier stages.”

As a result, rural populations tend to have more chronic and expensive health problems than their urban counterparts.

Bailey said the marketplace could help change this by providing rural residents with more and better options in the individual insurance market. And for those who are eligible, the marketplace provides financial assistance for consumers to pay for premiums.

But the marketplace website,, still has its glitches. Even if the website is working fine, the groups working to raise awareness about the new marketplace have a long way to go in rural areas.

“It’s going to be difficult,” Bailey said. “It’s difficult to reach rural people spread over large areas, but I think we’ve seen groups doing it one town at a time, and I think that’s how we have to do it in rural areas.”