In a long-awaited ruling, the United States Supreme Court determined today the constitutionality of the Patient Protection and Affordable Care Act, upholding all parts of the law.
Many Americans have found themselves in a state of confusion over "Obamacare" or the "Healthcare Reform" as it also has been called, because the law has many provisions, especially for rural Americans.
"In a lot of respects, this is a very rural-focused law," said Jon Bailey, Director of Research and Analysis at the Center for Rural Affairs. "It talks about the rural healthcare infrastructure system, how we pay for that, how we incentivize that, and how we get people to become healthcare professionals in rural areas."
Regardless of today's Supreme Court decision, the Affordable Care Act still has an effect on rural American healthcare.He said many rural Americans are already taking advantage of some of the provisions in the law, and today's ruling allows them to keep doing so.
"[The decision] keeps the law in place, and I think it adds a little certainty, maybe not clarity, but at least certainty," he said. Bailey said that today's decision reinforces that the law is the law, and states that maybe aren't as ready as some to adopt the changes will have to play catch up.
"Overall, now we are able to move on, and we have cleared away all the legal dispute," Bailey said. "Today was an important step in getting it clarified and legitimized."
Benefits to Rural Communities
Bailey said the benefits to rural communities in the ACA are extensive, including several provisions for rural health facilities, financial assistance to bring in extra doctors and hospital staff, and funding for preventive services. He said provisions in the insurance portion of the law may also help more rural businesses and farms find ways to insure their employees.
"Over the long-term, there are a lot of provisions in the law that provide incentives and initiatives to get more healthcare professionals in rural areas and also to support the basic healthcare infrastructure, our hospitals and clinics," Bailey said. "Overall, those things are going to be very helpful because access to healthcare is vital in rural America."
However, much of the debate surrounding these additional services and benefits has been focused on the healthcare mandate, which Bailey says maybe shouldn't be getting quite as much attention as some other portions of the law.
"The most important thing is that there is a lot more to [the ACA] than what we have heard. There is a lot more in there for rural people and over the coming years, those provisions are going to become even more important to rural places and as people continue to need healthcare."
Benefits Come With A Cost
Bailey admits that along with these benefits come significant funding challenges that may have to be addressed as the time comes.
He said the ACA attempts to tackle some of those funding challenges, but doesn't fully solve them.
"I think that is maybe the next big part of healthcare—we are probably never going to reverse the costs, but how can we control it? The ACA doesn't really address that but that’s the next big issue on the horizon," he said.
The ACA, which is modeled after Massachusetts' 2006 reform law, Bailey said, will work much like it did then. While funding is an issue, some are reluctant to support a law that isn't "perfect right off the bat," he said.
"It is an experiment. We know how it worked in one state, but that doesn't mean it will work the same in any other state. So I think that is the biggest argument against the affordable care act."
Expect Continued Debate
After the ruling, farm groups also filed their reactions. American Farm Bureau Federation President Bob Stallman said the Farm Bureau was "concerned" over the potential increases in costs for businesses and individuals.
He said the plan reviewed by the Supreme Court would "impose a new financial burden on our members" and called for a market-based reform, encouraging members of Congress and President Obama to address remaining concerns surrounding the ACA.
However, the National Farmers Union supported the findings of the Supreme Court, and praised the "significant, necessary reforms that help all Americans…afford insurance and the preventive care they need."
Moving forward, Bailey said that there will likely be continued debate surrounding the ACA in the months and weeks leading up to, and even after, the Presidential election.
"We have theories, we think we know how it's going to work, but until it's put into place, we're not sure," he said. "When you do something this big and affecting this many people there's going to have to be some changes as we go on."