Darvin Bentlage鈥檚聽health insurance plan used to be the same as all the other cattle farmers in Barton County, Mo., he said: to stay healthy until he turned 65, then get on Medicare. But when he turned 50, things did not go according to plan.
鈥淲ell, I had a couple of issues,鈥� he said.
That鈥檚聽putting it mildly.
Over two years, he dealt with聽hepatitis C and diverticulitis. That was on top of his persistent kidney stones, diabetes and other health problems.
鈥淚 had to go back and refinance the farm,鈥� he said. 鈥淏y the time the two years was up, I had run up between $70,000 and $100,000 in hospital bills.鈥�
He does not want to end up in that situation again, so he is paying close attention to what聽Republican working its way through Congress might mean for him.
He racked up those medical bills in 2007. Bentlage said that given聽his聽preexisting conditions, health insurance became impossibly expensive 鈥� a problem聽because聽he needed more health care. So when the Affordable Care Act exchanges opened in 2013, he said, 鈥淚 was probably one of the first ones to get online with it and walk through it.鈥�
About of the people on the exchanges are between 55 and 64, and they have than younger people do. So they have a lot on the line if the Affordable Care Act gets replaced. Under the GOP plan, older people鈥檚 insurance cost could , but the subsidies would be capped at $4,000. That鈥檚 less than half of what Bentlage is getting now under the ACA.
鈥淎nd my estimated income is less than $20,000. So I鈥檇 have to go back to Plan A and hope I make it to 65, you know?鈥� he chuckled.
Insurance premiums tend to be higher in rural areas where the population tends to be older, poorer and sicker than elsewhere. And Maggie Elehwany of the National Rural Health Association said there鈥檚 another issue: 80 rural hospitals have across the country since 2010.
鈥淲e鈥檝e got an access crisis going on,鈥� she said. 鈥淲hat this House bill does is nothing 鈥� nothing to address the rural hospital closure crisis. You鈥檝e got to understand that so much of that is linked to not only the health, but to the economic vitality of the community. If a hospital closes in a rural area, it closes for good.鈥�
One reason for these hospital closures is that 19 states, including Missouri, 聽Medicaid, which left poor rural patients uninsured. The GOP proposal would cut Medicaid more over time.
Bentlage said his county recently increased property taxes to keep its hospital open.
鈥淚t falls on the farmers,鈥� he said. 鈥淢y property tax on the hospital went from about $80 to about $400. And it鈥檚 still in trouble.鈥�
Missouri鈥檚 Republican congressional delegation Obamacare has failed. And Bentlage, whose positive experience with the health law once was featured in a healthcare.gov video, said the ACA does need work.
鈥淭here鈥檚 problems with it,鈥� he said, 鈥渂ut I don鈥檛 think it鈥檚 worth scrapping.鈥� All you need to do, he said, is look at how it鈥檚 helped him.
This story is part of a partnership that includes , and .