Health and Human Services Secretary Kathleen Sebelius on May 4, 2009 released a new report outlining the health care challenges facing rural communities, Hard Times in the Heartland: Health Care in Rural America. The report available at http://healthreform.gov/reports/hardtimes/ indicates that nearly 50 million people in rural America face challenges accessing health care. Not only do these Americans face higher rates of poverty, they report more health problems, are more likely to be uninsured, and have less access to a primary health care providers than do Americans living in urban areas. The report notes:
- Nearly one in five of the uninsured — 8.5 million people — live in rural areas.
- Rural residents pay on average for 40 percent of their health care costs out of their own pocket, compared with the urban share of one-third.
- In a multi-state survey, one in five insured farmers had medical debt.
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