Implications

According to a Chartis Center for Rural Health report, in states that expanded Medicaid, 36 percent of rural hospitals had a negative operating margin in 2015 while in states that did not expand Medicaid, 47 percent of rural hospitals had a negative operating margin. About 18 percent of rural hospitals in Medicaid-expansion states and 30 percent in non-Medicaid-expansion states had an operating margin lower than negative 5 percent.

In this case, “access” does not accurately represent what it is intended to. While access to insurance, vital in our current healthcare model, has increased, proximity to care facilities in poorer, more rural areas populated increasingly by Black and Indigenous People of Color has plummeted. Unfortunately, having an insurance card does not guarantee one to what insurance is intended to provide-- actual care from actual medical professionals. This is emblematic of the wicked problems presented by neoliberal policy. Data collected through national health surveys, essentially market research, fails to provide a more expansive and clear vision of problems affecting the most vulnerable populations in our country. Data collection’s utility, on the surface, lays the groundwork for advocacy. But representing the data as emblematic of the betterment of population health based on “access” is at best naive and at worst nefarious.