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Follow us on TwitterA new white paper released by The Iowa Policy Project focuses on the disparities at play when rural residents seek health care insurance.
“[This report] really highlights that the need for health reform that isn’t limited to people who are working outside their home — that it is a big issue for those who are self-employed and for people across the country,” said Andrew Cannon, a research associate with IPP and author of the study. “It’s not just an urban issue. It’s not just a rural issue. It’s an issue that touches Americans from all walks of life. Health reform needs to address the needs of all populations, including America’s rural population.”
Nearly 20 percent of America’s uninsured live in rural areas, according to the study, and are more likely than residents of urban areas to purchase their insurance on non-group, private markets where they typically pay higher costs.
The latest white paper from The Iowa Policy Project highlights the disparities facing rural Americans in need of health care insurance. Click graphic to view full PDF.
“The situation really is not sustainable barring some sort of reform,” Cannon said. “What we’ve seen over the past 10 to 20 years is that medical inflation, and health insurance inflation in particular, far out-stripping wage inflation. So, health insurance costs are going up 7 to 8 percent each year for this population while their wages are increasing 3 percent, if that. This is especially true in a recession like we are going through now, where people’s wages are stagnant or decreasing and yet their health insurance cost is increasing by 7 or 8 percent. That just puts this on an unsustainable trajectory.”
As The Iowa Independent has outlined as a part of its rural health care series, residents in these geographic areas often have lower incomes and higher poverty rates, but seldom meet income and asset guidelines necessary to receive assistance through existing public health insurance options like Medicaid and the Children’s Health Insurance Program. The study estimates that 1.2 million rural residents in Iowa “need increased access to affordable, quality health insurance.”
The white paper also provide the first-hand account of a Grinnell farming family that is attempting to navigate health insurance in the current system.
“It’s irksome that I’m a healthy person and I can’t get decent health insurance,” Suzanne Castello is quoted as saying in the narrative.
Castello, who had hoped to be able to purchase non-group, private insurance once she left outside employment and began to run the family farm with her husband, soon learned that the process would not be as easy as she thought. When the couple learned that they were expecting a child, the pregnancy was added to a list of pre-existing condition exclusions for which no insurer wanted to help pay.
“We were hemorrhaging money, but we didn’t qualify for Medicaid,” Castello said. “It really rankles me that we’re seeing something as fundamental as childbirth as kind of like, ‘Would you like dessert with that meal?’ There’s a double-standard between group policies and individual policies, which cover most farmers.”
Nationally, Castello is far from alone. Researchers have taken a keen interest in rural women who, despite a desire to work full-time on the family farm, have accepted off-farm employment solely for health care insurance. The phenomenon is known as “third shift,” due to often sleep-deprived realities held by the women who attempt to juggle work, family and farm duties.
“I have looked at some of the research on the third shift and that is a growing issue for a lot of rural families,” Cannon said. “As far as numbers go, I’m not sure and I wouldn’t want to peg a number. What we do know is that while 8 or 9 percent of the population in the U.S. gets insurance on the non-group, private market, in rural areas in Iowa it is a much higher rate — up to 37 percent in some parts of rural Iowa.”
It is very difficult overall to provide an accurate picture of what’s happening in rural Iowa in terms of health care insurance. While there is very good data available to provide a national picture, no such data exists on the local or state-level. That’s why, Cannon says, white papers like this are important.
“I don’t think it is something that most people are aware of — particularly with the rate of uninsured,” he said. “That’s because the current surveys … don’t get large enough sample within individual states for us to really get any good information. So, we know what the picture looks like nationally, but it is a little bit harder to get to it on a state level, which I think makes awareness of the issue much more difficult for people.”
