Big changes are coming to health insurance starting October 1st, when millions of uninsured Americans have to start buying policies under the Affordable Care Act. Jon Bailey, at the Center for Rural Affairs, says rural residents in Iowa tend not to get preventative screenings, like cancer tests or mammograms.

“The screenings and the tests are relatively inexpensive and do pay off and rural people, the data shows, get those in significantly fewer amounts than non-rural people,” Bailey says. “I think that’s because of the type of insurance they have.” Compared to urban residents, Bailey says rural Americans are responsible for nearly 22-percent more of their total health care costs, including premiums, co-pays and out-of-pocket costs.

The center’s research finds rural Iowans will see many pluses from the new federal health care law. Bailey says they focused on the provisions of the law, including tax credits and whether the costs can be subsidized. Bailey says, “Because of the insurance market in rural areas, because of lower incomes generally in rural areas, we think a good chuck of premium tax credits will go to rural people and a lot of rural people will benefit from them.”

Bailey, the center’s director of rural research and analysis, authored the report which looks at the benefits of health insurance marketplaces, cost sharing and other incentives for rural residents. “We hope it shows the process people will have to go through and if they purchase insurance on the new health insurance marketplaces, what they’ll potentially get in terms of premium assistance to help pay the health insurance costs,” Bailey says.

“It shows how those premium assistance provisions work, who qualifies for those.” Bailey says many provisions of the new law apply to rural residents because of demographics, unique health care challenges and economic circumstances. The Center for Rural Affairs is based in Lyons, Nebraska.