Use sample-copy power to inform all in your county about health reform

September 10, 2013

On Oct. 1, states and the federal government will open online marketplaces for health insurance, which will also offer subsidies based on income—and the opportunity for the poor to enroll in the Medicaid program in states that have expanded it above the poverty line. By March 31, almost all Americans must have health insurance or pay a penalty.

These steps will implement the health-reform law that Congress passed in 2010 and that even the White House calls Obamacare. It will be one of the most complex and challenging changes in American society since World War II, and newspapers are starting to help their readers get ready for it, going beyond the continuing political debate to the practicalities of the new system.

Community newspapers are part of that, and most of them have a special tool that can get important information to some of the people who need it most. Papers that use the mail can send up to 10 percent of their annual in-county circulation to non-subscribers at subscriber rates.

The Institute for Rural Journalism and Community Issues has long urged community papers to do this with their health sections, because there’s a big overlap among people who most need such information and people who do not subscribe to their local newspaper. Newspapers can sell enough ads to cover the extra printing and postage costs, or even sell sponsorships for the additional circulation.

We did a Rural Blog item about one weekly newspaper that sent a special health section to all the households in its county: the Adair County Community Voice in Columbia, KY. Editor and Publisher Sharon Burton told us in an e-mail, “We’ve had numerous compliments from readers who had said it was the best compilation of information they have seen in one place.”

The Voice doesn’t put much of its news online, but you can download its health section from our site at Our blog item about it is at The section is business-oriented, because Burton got much of her information at a Chamber of Commerce seminar. Broader sources include, the main federal site on the topic, the Kaiser Family Foundation, at, and the state agencies running the insurance exchanges.

One good thrice-weekly publisher, Willie Sawyers of The Sentinel-Echo in London, KY, reports good results from a special health section of 11, half-page units and alternate covers, prepared by Green Shoot Media, which specializes in special sections.

Hospitals and doctors: Some rural hospitals fear Obamacare will hurt them, by eliminating bonuses they get for serving a disproportionate share of Medicare and Medicaid patients. Another program, which gives small, rural hospitals small bonuses in return for limiting beds and services, is the Critical Access Hospital program. Now federal officials may be considering a move that take most hospitals out of the program.

Federal rules require such hospitals to be at least 35 miles from another (15 miles in mountainous terrain) but until 2006, states could waive that rule, and most hospitals in the program were waived in. Last month, a federal report said billions of dollars could be saved if they were disqualified. Our blog item is at

Many rural areas are short of doctors. The time to recruit physicians is not when they are in medical school, the provost of an Oklahoma medical school told civic leaders in the town of Woodward. She said rural towns need to get local young people interested in medicine and returning home to practice. The Woodward News reported on it and we blogged it at

Obamacare will worsen the rural doctor shortage by increasing demand for medical services, so there will be more competition than ever to recruit physicians. In some places, local doctors resist recruitment of new ones. Our item on a former hospital administrator’s column telling how he overcame such resistance is at

Many rural areas are also short of dentists. Some states are trying to lure more dentists to rural areas through incentives or by educating the area’s youth about dentistry and practicing close to home. We wrote about it at

Pipelines: The natural-gas boom is changing the nation’s energy transportation system. Pipelines that have carried gas from major production areas are being re-purposed to carry flammable liquids made from gas in new producing areas to refineries in the old areas. That has raised questions about safety, fairness and pipelines’ legal powers, and we noted it at

Some concerns about pipelines stem from recent accidents. The investigation of an ExxonMobil oil pipeline spill in Mayflower, AR, revealed a manufacturing defect in an outdated construction process that produced pipe for many other lines. The industry says proper monitoring and prevention measures keeps pipelines safe, but ExxonMobil has not revealed whether it met those standards at Mayflower, Inside Climate News reported. We noted it at

Broadband: High-speed Internet access in rural areas can be spotty, and doesn’t exist in some places. What is its availability in your area? The National Broadband Map allows you to type in a place name and see all its broadband providers and their advertised speeds. There is also a tool to compare data within areas. See our blog item at

Rural areas are much more likely to have broadband than they were a decade ago, but they still lag behind metropolitan areas, partly because rural areas tend to be poorer and older. Researchers wrote in the Daily Yonder that more should be done to promote the importance of broadband adoption; we noted it at

Other issues: Drug problems plague many rural areas, and judges in such areas may levy harsher sentences against drug offenders than in urban areas because the offenses are bigger news in small towns. The Columbus Dispatch found that, in reporting that Ohio prisons are filling up with rural white women, many on drug convictions. See

Are your local police stocking up on surplus military gear? The program is rarely monitored, and requests are being granted for millions of dollars’ worth of supplies that police stations can’t use, such as scuba equipment in areas with no water. See

If you’re in a community where floods are a threat, you should know that flood-insurance rates are rising because a new federal law requires premiums to better reflect the risk of flooding. Also, the government is “redrawing flood-zone maps that will classify more properties as flood risks,” The Wall Street Journal reported. Our blog item is at

Rural areas are generally short on philanthropy, but local philanthropic efforts can bridge economic, social and cultural gaps, bringing people of differing backgrounds together to form a common bond, Max Rose wrote for Nonprofit Quarterly, and we noted it at

You’re welcome to reprint our Rural Blog items as news; they always contain credit for the original source, and if you use one, we’d appreciate a credit line. If you do or see good rural journalism, tell us about it so we can put it on the blog at


Al Cross edited and managed weekly newspapers before working 26 years at The (Louisville) Courier-Journal and serving as president of the Society of Professional Journalists. Since 2004 he has been director of the Institute for Rural Journalism and Community Issues, based at the University of Kentucky.

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