Perceived Barriers and Impact of Implementing ACA in a Rural Community

Background: Beginning April 1, 2014, all United States residents will be required to have health insurance.  As the plan has been developed and revised, concerns about the requirement for each individual to obtain health insurance have risen to the forefront. Rural communities, which already experience poor access to healthcare, are now trying to determine how the Affordable Care Act (ACA) will further influence their healthcare access. This study was conducted to identify the perceived barriers and impact of implementing the ACA in a rural community.

Methods: Key informant interviews, physician interviews, and community focus groups were conducted to identify knowledge levels about the ACA in general and the individual responsibilities related to the ACA.

Results: Study results revealed that neither the ACA policy in general, nor individual requirements are well understood.  Community physicians are unsure about the impact of ACA on their practice, or within the community, at such an early stage of implementation. Some residents are aware of their responsibilities under the healthcare law but many are not. Several participants view the ACA as financially negative and are aware of the imposed penalty if insurance is not acquired.

Conclusions: Results suggest that education about the ACA may be lacking in southern rural communities. More education may be necessary to ensure residents are adequately informed to fulfill their obligations related to the policy. The view of the ACA as financially negative should probably be addressed in an effort to ascertain southern rural residents are able to financially access health insurance.