By Kelly Cantwell
Editor

Only 21 percent of those eligible for Affordable Care Act health care in rural areas have signed up since open enrollment began Nov. 1.

While Ohioans who live in cities are signing up at the same rate or higher than in previous years, rural Ohioans have not been. As the end of open enrollment for 2016 creeps closer, Ohioans in rural areas are being encouraged to sign up, said Tony Logan, U.S. Department of Agriculture Ohio Rural Development State director.

Nationally, the uninsured rate is below 10 percent for the first time, said Kathleen Falk, regional director of U.S. Department of Health and Human Services region five. However, there is still more to do and there are unique challenges to get those in rural areas to sign up.

Jan. 15 is the last day to enroll in plans for coverage staring Feb. 1 and Jan. 31 is the last day for open enrollment. Those who enroll after Jan. 15 will have coverage beginning March 1.

The Rural Policy Research Institute did a study and found that out the of 35 states that use the federally facilitated or state partnership marketplace, Ohio had the third lowest rate of rural enrollment, Logan said.

“We have a great deal of room for improvement in this area,” Logan said.

The USDA and the HHS are trying to improve the rural enrollment rate by reaching out to those areas, Logan said.

The ACA has improved healthcare for rural customers, Falk said.

Before the ACA, rural uninsured typically paid about half of their medical bills out of pocket. They were more likely to suffer from chronic conditions, be older, have a lower income and be self employed than their urban counterparts, Falk said

“Rural residents share a common set of values, and that includes strong family ties. Healthcare is something that you should seriously consider for your family and yourself simply because it creates a stable economic family unit, and it’s not difficult to get into one of the plans now,” Logan said.

This year about six out of every 10 statewide are eligible for a healthcare plan that costs $75 a month or less because of a tax credit, Falk said.

However, those who do not enroll in coverage will be fined either $695 or 2.5 percent of their income, whichever is greater. In addition, it prevents people from going bankrupt because of medical costs, Falk said.

Falk is not sure why enrollment is so low in rural Ohio. However, she feels one reason could be a lack of awareness about the ACA, even though this is its third year.

“For people who have been chronically uninsured, many still do not know that this new opportunity exists,” Falk said.

Logan also feels that people may not understand the ACA. However, he wants to reassure people that the signup is easy and there are people who will help with signup for free. Logan also stressed that many new enrollees are paying $100 or less in premium costs.

In addition, some may think that the insurance only covers catastrophic costs, Logan said, which is not the case.

According to federal law, plans need to have 10 essential benefits, which include preventative service, hospital bills and mental health services, Falk said. There are 81 plans available in Ohio this year, up from 70 last year.

For those who enrolled in the ACA in 2015, Falk encourages customers to shop around rather than automatically reenroll in the plan they had last year. Most customers can get the same level plan for less by shopping around, she said.

“We know that buying health insurance can be complicated, especially for those who have not had it before but these is assistance available all across rural Ohio,” Falk said.

For more information about plans or assistance, go to healthcare.gov or areyoucoveredohio.org, or call 1-800-648-1176.

For small businesses, the ACA has a shop so employers can purchase plans through the federal marketplace. It is open year round, Falk said.