Understanding the Effect of the Affordable Care Act (Obama Care) on Rural Primary Health Care Selection

This study examines the effects of the Affordable Care Act (ACA) on both the reported satisfaction and the selection of rural primary care providers (PCP). Although there is a growing body of research on rural health care PCP... [ view full abstract ]

This study examines the effects of the Affordable Care Act (ACA) on both the reported satisfaction and the selection of rural primary care providers (PCP). Although there is a growing body of research on rural health care PCP selection, little is known about how the major changes to the US health care system enacted by ACA effect rural health care satisfaction and selection. To examine the effects of the ACA on rural health care this research uses data from the Rural Utah Community Study (RUCS). The RUCS gathered self‑reported information from rural Utah residents on their physical and mental health status, health‑care utilization patterns, satisfaction with local health care services, and health‑care access issues. Measures of family, community, and demographic characteristics provide the social context for the reported health‑care experiences. Furthermore, questions about the effects of the ACA on rural health care were part of an experimental design in the RUCS that allow this research to separate the perceived impact from the actual impact of the ACA on to local health care and PCP selection. The specific research objectives of this project are: (1) to understand the difference in the perceived and actual impact of the ACA; (2) how do demographic, community attachment/satisfaction, and political identification shape the reported effects of the ACA on local health care; and (3) does a negative perception of the ACA increase the likelihood of rural bypass behavior, were rural residents skip local PCP in favor of PCP located outside their community. The results of this research will provide important insights into how macro-level changes in the US health care system impact local health care for rural residents.