The Healthcare System in Rural America Could Change Soon

The Supreme Court's upcoming ACA case could drastically change the healthcare system in rural America.

Although Election Day 2020 is behind us, the battle surrounding the constitutionality of the 2010 Affordable Care Act (ACA) is far from over. The Supreme Court will begin the case hearing on November 10, though a final verdict will likely take months. This court case will be monumental, regardless of the outcome, but former Kansas Governor and Secretary of the U.S. Department of Health and Human Services Kathleen Sebelius says that the decision could devastate the healthcare system in rural America.

Effects of the ACA on Rural Populations

A rural area is defined as anything outside of Metropolitan Statistical Areas (MSAs), which must surpass 50,000 residents and have attached or surrounding suburbs. According to the Kaiser Family Foundation, approximately 50 million people live in rural areas across the United States.

Rural residents are frequently low-to-mid income and have different cultures and needs than residents of urban or suburban areas. Currently, nearly two-thirds of rural individuals lacking health insurance reside in states that voted not to expand Medicaid, which provides help to those of similar income levels in other states. As of October 2020, 38 states plus DC voted to expand Medicaid services.

Over the last decade, 133 hospitals in rural areas have closed across the nation. The majority of these were in states that did not expand Medicaid.

COVID-19 in Rural Populations

Currently, America is seeing a drastic rise in the number of positive COVID results coming from rural areas. This uptick in cases is coupled with the fact that rural hospitals are typically less equipped to handle major medical emergencies. Unlike some conditions, where patients can be transported to larger facilities, many of the hospital beds designated for COVID-19 patients are already taken. The smaller hospitals are sometimes used for overflow patients, but they are often not as well-equipped or staffed as their larger counterparts.

“You can’t save a COVID patient if you don’t have highly trained personnel and the medical equipment with which to treat them,” said Sebelius. “It’s a nightmare waiting to happen, and we are seeing it play out right now in the United States.”

The Court Case in Question

The Supreme Court will hear the case in opposition to the ACA on November 10, though there will likely not be a final decision in the case until spring 2021 at the earliest. During the deliberation, the Supreme Court will vote on the constitutionality of the ACA, which protects approximately 133 million Americans with pre-existing conditions, following the elimination of the individual mandate in 2017.

If the constitutionality of the ACA is proven false in the November hearing, 20 million Americans would lose access to their health care coverage. Many of these individuals live in rural areas with already limited access to health care resources and quality medical services. Especially now, in the second wave of the coronavirus pandemic, the decision made in this case could change the way rural citizens receive health care for generations to come.


We hope this information on how the ACA Supreme Court decision could drastically change the healthcare system in rural America is helpful to you.

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