In about a year, my life is going to change dramatically. That is because my husband will graduate with his education degree in December and we will be returning to the northern tier,six miles outside a town of under 400 people, where our parents grew up and where his father still lives, and gave us the land to build on years ago.

It won’t be totally alien. We went to high school there ourselves, and the kids my husband will be teaching he will disproportionately be related to. This is rural remote – we have had a bank account there since before the bank had account numbers. Seriously. We bank at a bank that has only had account numbers for about 25 years, when they got the first computer.

There’s an old David Allan Coe song that sums up where we’re from perfectly…If that ain’t country…I’ll kiss your ass.

And in about a year, I will be back there, thirty years after leaving, and five years after the realization that the day was looming that family responsibilities will dictate that we be there for his father who has certainly never let us down. He is about to turn 80, and that was the deal – we’ll go home when Dad is 80, so we’ll be there if he needs us.  

Life will be much different there than it is here, and it will take some serious adjustment on my part. But I will not face the hardships that my neighbors and classmates who never left have always faced. A minimum income that I can live off of quite comfortably there is guaranteed, and so is my healthcare, and unlike them, I will still have a home and a medical team in Kansas City.

Healthcare access is already approaching ‘crisis’ in many rural areas, and according to a study released in February by the Center for Rural Affairs, if legislation to reform healthcare fails, it is going to get much, much worse.

If the status quo, where one in five rural Americans already lack coverage, continues apace, over 25% of rural residents will be without coverage by 2019. And the picture is even more grim for the residents of remote rural areas, defined as those with a population center of less than 2500. In those areas, the rate of uninsured is already higher. It currently stands at 23 percent and will rise to 32 percent by 2019 if the reform efforts fail.

All of the problems that exist across the spectrum are magnified in rural areas, especially premium increases. Farmers, ranchers and other independently and self-employed people disproportionately pay the full freight of their coverage, which makes them more likely to be underinsured and devastated by an illness or accident. In addition, they are already less likely to seek and receive preventive services.  

This reality hit our family hard last summer when my husband’s 36-year-old cousin Jen got sick, then got sicker, and by the time she saw the doctor, she was immediately admitted to the hospital, but it was too late. She died of respiratory failure about three days later, leaving two teenagers without their mother, her husband, her high-school sweetheart, crushed and an entire community, devastated.

And that, friends and neighbors, is the human cost of doing nothing.