The U.S. Supreme Court will likely rule on the fate of the federal health care reform law this Thursday. That ruling could affect provisions of the law aimed at improving health in rural America.
In the more than 2,000 pages that make up the Affordable Care Act, there are handful of measures specifically designed to expand access and insurance coverage in rural areas.
"There is a disproportionate number of rural uninsured and underinsured, than in urban areas," said Maggie Elehwany, the National Rural Health Association.
"Our primary issue was, it doesn't really matter if you have this brand new insurance card, if you don’t have access to a provider."
The law President Obama signed in March 2010 included things like grants for rural physician training, and allocating more residency slots for young doctors in rural areas. The law also makes adjustments to Medicare that help rural hospitals.
Elehwany said even if the Supreme Court only strikes down part of the law, these provisions could be in limbo.
"If only part of the bill is stricken, these rural provisions will remain in effect. But will they ever be realized to the full potential? That remains to be seen."
Money from the health reform law has already been flowing into Missouri – for example, community health centers – mostly in rural parts of the state have gotten more than $61 million since 2010.