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Health-Care Initiatives, Strategies, and Challenges for People with Disabilities in Rural, Frontier, and Territory Settings

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Disability and Vocational Rehabilitation in Rural Settings

Abstract

The purpose of this chapter is to examine the implications of the US Affordable Care Act (ACA) for rural residents with disabilities. Special attention is given to rural health disparities, challenges of health-care services, availability of medical providers, and the confluence of poverty. Barriers to health care and health delivery that significantly impact health outcomes for rural residents are highlighted. Most importantly, it suggests that the Affordable Care Act has substantially decreased the number of uninsured individuals and established a number of provisions to impact the quality of health care in rural communities. However, even after the Affordable Care Act, health inequities remain. Further, this chapter explores proposals to improve rural health services and presents initiatives to “tweak,” replace, and expand the Affordable Care Act.

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Author information

Authors and Affiliations

  1. University of North Texas Department of Sociology, Denton, TX, USA

    Erma J. Lawson

Authors
  1. Erma J. Lawson
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Correspondence to Erma J. Lawson .

Editor information

Editors and Affiliations

  1. Department of Early Childhood, Special, Education, and Rehabilitation Counseling, University of Kentucky, Lexington, Kentucky, USA

    Debra A. Harley

  2. College of Health and Human Services, Rehabilitation Services and Rehabilitation Counseling, Northern Illinois University, DeKalb, Illinois, USA

    Noel A. Ysasi

  3. Department of Early Childhood, Special, Education, and Rehabilitation Counseling, University of Kentucky, Lexington, Kentucky, USA

    Malachy L. Bishop

  4. Pennsylvania State University, Rehabilitation and Human Services, University Park, Pennsylvania, USA

    Allison R. Fleming

Learning Activities

Learning Activities

Self-Check Questions

  1. 1.

    What are the major service delivery and insurance reform provisions in the Affordable Care Act?

  2. 2.

    What social conditions were prevalent during the creation of the ACA?

  3. 3.

    What are the challenges of the ACA to improve the health of rural, frontier, and territory residents living with disabilities?

  4. 4.

    What are the limitations of the ACA?

Experiential Exercises

  1. 1.

    Interview a young (between the ages of 30 and 40) and an older recipient (aged 50 and older) of the ACA in a rural, frontier, or territory community to determine their experiences and perceptions of the ACA. Determine the evaluation of the ACA as it relates to service delivery, quality of care, as well as access to care. Compare their views of ACA.

  2. 2.

    Visit a Medicaid/Medicare office to interview a human service provider in a rural, frontier, or territory community to determine their experiences with ACA. Determine the person’s evaluation, challenges, and limitations of ACA. In conducting the interview, use open-ended questions, such as the following:

    1. (a)

      Tell me about your experiences with Medicaid/Medicare clients before ACA.

    2. (b)

      Discuss your experiences with Medicaid/Medicare clients after ACA.

    3. (c)

      If you could change ACA, what changes would you make?

    4. (d)

      Tell me your thoughts regarding the ACA.

      Be sure to thank the interviewee for his/her time.

      Write a paper on the results of your interview.

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Lawson, E.J. (2018). Health-Care Initiatives, Strategies, and Challenges for People with Disabilities in Rural, Frontier, and Territory Settings. In: Harley, D., Ysasi, N., Bishop, M., Fleming, A. (eds) Disability and Vocational Rehabilitation in Rural Settings. Springer, Cham. https://doi.org/10.1007/978-3-319-64786-9_5

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