Click to expand Image Pineville Community Hospital, Pineville, Kentucky. © Americore Health Solutions

Rural America is in the midst of a health emergency that will probably get much worse if the US Senate’s healthcare bill passes.



According to the US Centers for Disease Control (CDC), people who live in rural areas are more likely to die of all of the five top causes of death, including heart disease and cancer, than their urban counterparts. Making matters worse, on average the 46 million people living in rural areas – 15 percent of the US population – are older, sicker, and have less access to health care than those who live in urban areas, and the gap has widened in recent years.



The Senate bill, currently a discussion draft, would leave millions of people across the country without health insurance, but those in rural areas are likely to be hardest hit. Most of the damage would be done through the bill’s decimation of Medicaid. Like the House’s healthcare bill, the Senate’s draft legislation includes a US$834 billion reduction in Medicaid spending over the next decade. Unlike the House bill, this spending cut would hit after 2020.



Today, 700 rural hospitals are already in danger of closing their doors due to federal budget cuts. Experts predict a dramatic rise in that number if either the Senate or House legislation is signed into law.



Cuts to Medicaid would also exacerbate the overdose epidemic that is raging in rural counties throughout the nation. Although all states have experienced increases in opioid use and overdose deaths in the past decade, the heaviest concentration of deaths are in states with large rural populations such as Kentucky, West Virginia, Alaska, and Oklahoma. Many factors, such as poverty and unemployment, contribute to this disparity. But health insurance has proven to be a primary lifeline to recovery. Medicaid is the largest single source of health coverage for substance use disorders. In states that expanded Medicaid under Obamacare, more than 1.2 million people have been able to get drug dependence treatment.



President Donald Trump and the Republican Party are in control of the White House and Congress largely because of the rural vote. This Senate health care bill would repay support at the ballot box with a punch to the gut.