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Medicare Alzheimer’s Policy Cuts Off Rural America

Access to health care is a challenge for rural Americans, especially with inflation driving up the cost of living and transportation. The issue is heating up is with Medicare limiting coverage of breakthrough Alzheimer’s treatments to major metropolitan areas. The disease kills nearly twice as many people in rural America compared to urban areas.

In January, FDA approved a new medicine that slowed disease progression by 27 percent—but Medicare didn’t budge. Last month, it doubled down on a policy restricting coverage only to beneficiaries enrolled in a handful of government-approved studies run exclusively in urban medical centers around the country. Everyone else must cover the cost out-of-pocket.

Writing in The Kansas City Star, Betsy Huber, President of National Grange, argues that this approach discriminates against rural Americans and should be reversed.

 Under the current policy, rural Americans have to travel great distances to have any hope of participating in these studies and gaining access to care they need.

The Alzheimer’s Association’s clinical study New IDEAS clearly illustrates the problem. This research focuses on the brain scans that help doctors diagnose Alzheimer’s by providing visual confirmation of amyloid plaques. The study seeks to enroll a diverse group of participants. But 18 states — including seven of the least populated ones — have no study sites. Kansas is among them. And Missouri has only one, in St. Louis.

Are people in rural communities less deserving than those in urban ones? High gas prices and broad-based inflation only amplify this inequity for rural Americans. Agricultural workers with limited paid leave will be hit hardest.

Medicare needs to change its policy, and it needs to do so now. People living with this dreadful disease do not have time to waste. The Food and Drug Administration approved the new treatment specifically for the early stage of disease. The Alzheimer’s Association estimates that every day, about 2,000 people transition from this early stage to a more moderate form of the disease, which means that at least some could miss the opportunity to benefit from the best available care.

Huber notes that a growing chorus of bipartisan lawmakers in Washington are calling for reform.

Our national legislators should use every tool to hold federal government agencies accountable for ensuring health equity for rural America. Field hearings, for instance, are a crucial way to bring Congress to their rural constituents who may lack the money and time to travel to Washington’s corridors of power.

Unless Medicare expands coverage to more of the country, millions of rural Americans and their families will be left behind.

The National Grange is a grassroots membership organization serving rural and small-town residents with community service and issue advocacy. You can learn more about its work here, and you can read Betsy’s piece in full in The Kansas City Star here.