HHS Secretary Kathleen Sebelius receives applause after her speech to the National Rural Assembly

U. S. Secretary of Health and Human Services Kathleen Sebelius is looking for a little help from rural advocates in spreading the word about the Affordable Care Act.

Sebelius addressed the National Rural Assembly on Tuesday, receiving a standing ovation as her talk began.

Sebelius said the Affordable Care Act (ACA) offers a once-in-a-lifetime opportunity to improve healthcare in America. 

“We can build a country together in which every American has the opportunity to build a healthy and prosperous life,” she said. “But we can’t do it without your help.”

The ACA will be important for rural Americans because they are disproportionately uninsured and suffer more from health problems such as heart disease and cancer, she said.

But rural Americans are also harder to reach with information about the healthcare act implementation, which includes a new online clearinghouse at https://www.healthcare.gov/ or toll-free at (800) 318-2596.

“I’m here to ask for some help,” she said. “Anything you can do to spread the word about the website will help. We’re not selling anybody anything. We’re just trying to provide information to help people make choices.”

She said President Obama believes that where you live shouldn’t determine your chance for a healthy life. 

“It’s a principle that I hope that we can all agree on,” she said. 

Sebelius said her knowledge of rural America came from her experience in Kansas, where almost all of the state’s 105 counties have significant and often entirely rural areas. “As governor (of Kansas) I never took my eye off what happens in rural America,” she said. “I learned early on that if you close a hospital or close a school, you close a town.”

The secretary said good healthcare is one of the most important ingredients for a thriving community. “Virtually no one is willing to live in a town where access to healthcare is threatened.”

The current snapshot of health in rural America is not a pretty picture. For farm families, one member must often take a job solely to get health insurance. In many rural communities, a single insurance company dominates the market, creating a practical monopoly in which insurers can charge what they want and make their own rules, Sebelius said. 

A new phase, however, begins October 1 when enrollment in health-insurance exchanges that are a cornerstone of the Affordable Health Care Act officially kicks off. New insurance markets will open in every state, and insurers will have to offer side-by-side information about coverage, Sebelius said. 

For the first time, “insurance companies will actually have to compete,” she said.

No one can be locked out due to pre-existing health conditions. Currently women pay up to 50 percent more than a man just because of gender.

“Being a woman will no longer be a pre-existing condition,” she said to applause.

Sebelius said healthcare.gov is not a typical government website – it’s easy to read, user friendly and interactive.  

For those without Internet access, there’s an always-open toll-free call center with translators to offer information in 150 languages. 

HHS will also be working with the Department of Agriculture Extension Service to get the word out.

Sebelius also addressed the debate over states’ acceptance of Medicaid expansion. There are dramatic differences among states about who qualifies for assistance under the program. The ACA seeks to standardize eligibility at 138 percent of poverty level, or less than $15,000 a year for an individual. States can expand Medicaid with federal assistance at any time, she noted.

HHS is also expanding the National Health Service Corps, which she described as the “Peace Corps of health care.” In exchange for paying off medical school debt, medical students agree to work in traditionally underserved communities, which are often located in rural areas. Many of the health-care professionals remain in the communities after they complete their initial service, Sebelius said. 

“We make a short-term investment; they make a lifetime commitment,” she said.

HHS is working to streamline forms for healthcare providers and provide new information technology services, creating telehealth networks that link doctors to trauma centers so patients don’t have to travel long distances for health care. She also noted progress in adopting electronic health-record keeping that will improve doctors’ access to patient information and ensure greater access for patients to their own health records.

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