The Affordable Care Act: "Concerns for rural Alabama"

Mar 27, 2014

All year long on Alabama Public Radio, we’re collaborating with on stories about the Affordable Care Act. The deadline to apply is Monday. However, if you’ve started the process, the deadline to finish applying is mid-April. The Obama administration says one concern connected to health care is Alabama’s rural community. Tim Vilsack sits on Mr. Obama’s cabinet as Secretary of Agriculture. APR’s Ryan Vasquez spoke with Vilsack on the specific problems rural residents of Alabama have with health care…

Secretary Vilsack: A higher level of outer pocket expense is spent by rural Americans for health care. Lack of access, poorer outcomes, and a significant increase in the number of uninsured Americans that live in rural America are all concerns of ours because it can be a drag on the economy. It can be difficult for businesses to attract quality healthcare for their employees. So it’s important for us to have folks understand the opportunity to sign up for the affordable care act because it will reduce the number of uninsured, it will lower the cost for preventative care services, it will provide access to healthcare for youngsters who have preexisting conditions, it will eliminate lifetime limits as an impediment to coverage. There are a lot of benefits to this law; we want people to understand that it is affordable and available and encouraging folks to go on the website or to call the 1-800 number which is 1-800-318-2596 for information on how to get healthcare coverage.

Ryan Vasquez: How do you appeal to rural America and say “look this is something that you need to do” V

ilsack: Well if you want access to good quality healthcare, you have to have a system that will be able to assure hospitals and clinics that they are going to be paid for the services that they are providing. In the past, with the high level of uninsured people in rural America, the hospitals and clinics did not have that certainty. And when someone who was uninsured came in for care and got that care, the cost of that was shifted to the people who did in fact have insurance and it just became a vicious circle. This law basically provides an opportunity for people who were previously uninsured to secure healthcare coverage for a reasonable cost and in some cases it can be $100 a month after the subsidies and tax credits are taken into effect, so it’s reasonable in expense. It allows people to have the peace of mind of having healthcare coverage and knowing that if they have a serious illness or they are involved in an accident, they’re not going to be financially devastated. It enables farmers and farm families to consider options in terms of working off the farm. Many farm families are required to do off farm work that they would love to be able to spend the time on the farm but they can’t because it’s the way in which they have been able to obtain healthcare coverage. Now they have an option, they have a choice. So there are a multitude of benefits in terms of securing access to quality healthcare, making sure you have peace of mind in terms of the cost of a serious illness or an accident that might occur and also allowing farm families in particular greater flexibility than before.

Ryan: Is it harder to get that message out to people when you run into issues in various states that either the state government isn’t doing anything to help it along or spread the word or there isn’t a lot of money in the state to help people enroll?

Vilsack: Well that’s why this is a person to person effort to the extent that we can get folks to get on that website or call that number and they learn how relatively simple it is, how relatively inexpensive it is. They can talk to their friends and neighbors, and word of mouth it spreads through the country side. That’s why we’re beginning to see significant increases in the number of people interested in this and this is very similar to the experience that took place in Massachusetts when they had a similar law at the state level. There was reluctance, there were issues, there were challenges, but as time went on folks learned more about the opportunities: Free preventative health care coverage, lower prescription drug costs for seniors, no preexisting illness exclusion for kids, no lifetime limit concerns if you have a serious illness. As people learn about the benefits of this and they look and see the cost after they take into consideration tax credits and subsidies. It’s going to be something that people gravitate to and states are now I think beginning to realize that there’s an opportunity to have health care coverage for folks that we won’t be shifting the cost of uninsured care to those who can afford health care coverage which is a burden on businesses. I mean if you’re basically paying for your employees health care and you’re also paying a premium for those who don’t have health care because somebody has to, the cost gets shifted and your health care premiums might be 10-15 percent higher than they would otherwise be. With this new law we should see moderation of those health care costs and we’ve actually begun to see that, health care costs are not going up as rapidly as they did. I think it’s the lowest increase in the last several decades and that’s going to be good for business as well. So I think it’s just a matter of people understanding the benefits and we keep making sure they go on the website, and call the 1-800 number.

Ryan: Do you feel that it’s going to pick up strong and get closer to that number everyone predicted at the start?

Vilsack: Well I think so. I think we’re at a point now where when you look at the Medicaid expansion and we look at the children health program expansion and you look at the folks who are going to the marketplace, you’re seeing a significant reduction in uninsured and that’s what it’s all about, you’re broadening the pool of healthy people so the cost should be lower for everybody and you’re going to see people receive the benefits of this bill and they’re going to talk to their friends and neighbors about it and over time I think you’re going to see a greater and greater acceptance. It is an education process, when we first started with Medicare there were issues and Medicaid there were issues. We’re working through these issues and I think as we do more and more people are realizing ‘hey this is not a bad deal, this is actually a good deal.’