Poll: Many Rural Americans Struggle With Financial Insecurity, Access To Health Care

National Public Radio is out with a new poll underlining what tons of rural Ohioans have known for years now: Many rural Americans are struggling with financial insecurity and access to health care. And it’s an important datapoint as 2020 gets underway, and leftist cries about “economic anxiety” being code for “racism” get louder.

Some key findings of the poll:

A substantial number (40%) of rural Americans struggle with routine medical bills, food and housing. And about half (49%) say they could not afford to pay an unexpected $1,000 expense of any type.

One-quarter of respondents (26%) said they have not been able to get health care when they needed it at some point in recent years. That’s despite the fact that nearly 9 in 10 (87%) have health insurance of some sort — a level of coverage that is higher now than a decade ago, in large part owing to the Affordable Care Act and the expansion of Medicaid in many states.


Of those not able to get health care when they needed it, the poll found that 45% could not afford it, 23% said the health care location was too far or difficult to get to, and 22% could not get an appointment during the hours needed.


One measure of financial security is the ability to meet unexpected expenses like a car repair or a medical problem or fixing something that has gone wrong in the house. It’s not unusual for these expenses to run $1,000 or more, so we asked whether that would be a problem.

Overall, nearly half (49%) said they wouldn’t be able to afford that. And more than 6 in 10 rural black and Latinx Americans said they would have a problem paying that off (blacks, 68%; Latinx, 62%), compared with 45% of rural whites.

This is important data for Ohioans for a couple of reasons.

First, as we all remember, former Gov. Kasich expanded Medicaid– but that hasn’t solved these problems. As the numbers above show, having health care coverage is not enough when patients are physically remote from health care providers, or providers are so overloaded from other rural providers closing that it’s tough to get an appointment.

Second, the financial data make clear that economic anxiety is very real for a lot of stereotypical Trump voters in Ohio. If one cannot afford an emergency $1,000 expense, that is inherently anxiety-inducing and a problem. “Economic anxiety” is not a talking point.

There are a few bits of good news here.

One is that President Trump has taken steps to bolster rural health care by doing things like setting rules affecting the 340B drug discount program on which lots of rural, working class voters rely but which also helps keep rural health care providers in particular functioning.

Another is that tax reform may help some of these Ohioans, particularly if they have children.

Further, starting under Gov. Kasich, parts of Ohio’s economy began to turn around and the Midwest in general seems to be benefiting from President Trump’s economic policies (damage to soybean farmers notwithstanding).

But the poll data shows there is still real trouble in rural America, a lot of which rests in Ohio. The question is will Democrats seize upon that to successfully shift the state in 2020, or are rural, white working class voters satisfied that their lot is improving enough under Trump to give him a second term? Our guess is the latter, but the numbers make clear there is still lots of work to be done.