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Guest Opinion: The ACA is vital to rural health care Sunday May 7, 2017 at 12:01 AM By Sen. Ron Wyden Quality rural health care always has been and always will be a fundamental foundation to sustain robust rural life in Oregon. Maintaining quality rural health care poses special challenges when hospitals and doctors may be a long drive or even a helicopter flight away, challenges made even harder by inclement winter weather. We must meet the challenge to protect the health and well-being of rural seniors, children and families. At the same time, health care generates good jobs at good wages, providing significant financial resources for smaller communities statewide. Because rural health care is so key, I’m holding a statewide rural health care listening tour this year. I’ve heard so far from doctors, nurses, patients, advocates and many others about what’s working and what needs improving to stay on the path toward quality care for all. One of my seven roundtables was in Medford. I plan additional Oregon rural health care meetings this year but so far can report these five takeaways from my meeting in Southern Oregon and the other half-dozen roundtables: 1) The Affordable Care Act (ACA) has produced real benefits for rural Oregonians. Rural health care providers overwhelmingly said many Oregonians have benefited from the ACA. I heard powerful personal stories of Oregonians whose lack of insurance pre-ACA had forced them to put off essential medical treatment because the mammoth health care expenses would have bankrupted them. Thanks to coverage under the ACA, those same people can now receive vital care that helps keep them healthy and providing for their families. I also heard how the ACA generated more cost-saving and life-saving preventive care, as well as access to caseworkers and behavioral health providers to help patients improve their quality of life. Health care providers also talked about the important connections they can make in coordinating services to link crucial mental health treatment, community resources and good physical health care. 2) Expansion of Medicaid in rural Oregon has been especially helpful. More than 1 in 4 Oregonians are enrolled in Medicaid — and that share exceeds one in three in some rural counties. I heard repeatedly how repealing the ACA’s Medicaid expansion would significantly decrease rural coverage and increase uncompensated care. That could force shutdowns of rural hospitals and clinics, many of which already have slim financial margins. Cuts to Medicaid would worsen the often-tough job of recruiting providers to rural Oregon, with the ultimate victims being rural residents needing health care. 3) Some of the heaviest impacts from repealing the ACA and slashing Medicaid funding would land on rural seniors and children and people battling opioid addiction. Rural seniors would be threatened because those older Oregonians tend to have chronic conditions and disabilities, and are more likely to enter nursing homes. I also heard how rural children could suffer because youngsters are disproportionately served through the Oregon Health Plan. And providers also spoke of how the fight to combat opioid addiction would become tougher if the expanded addiction treatment coverage under the ACA is lost. 4) Soaring prescription drug prices continue to undermine lasting health care solutions. There were harrowing tales about Oregonians facing prescription drug costs that place the treatment they need far out of financial reach. Providers and patients alike highlighted about the need to lift the veil of secrecy covering the opaque system of pricing prescription drugs. We discussed my bill that would require pharmacy benefit managers in Medicare to disclose their total rebates provided by drug manufacturers. The legislation also would disclose how much those rebates are passed on to health plans so prices are lowered for people needing prescription drugs. 5) Rural Oregon is hungry for solutions. Oregonians prefer proven innovations pioneered in rural Oregon over partisan standoffs that could reverse those gains. They say ideas are most likely to succeed when they emerge from the “Oregon Way,” prioritizing what works over partisan politics. I wholeheartedly agree. — Ron Wyden is Oregon's senior senator.