Alzheimer’s hits rural Kansans harder. And Medicare is cutting them out | Opinion

The scourge of Alzheimer’s disease is dire, and especially so for rural Americans, who live farther from the metropolitan areas where research centers are concentrated. Medicare just announced it will continue to restrict coverage for cutting-edge treatments to these urban centers. If it doesn’t address the geographic inequity of care, millions of Americans living in our rural heartland will miss out on this new hope.

More than 6 million people in our country suffer from this unforgiving and relentless disease, but the burden does not fall equally on urban and rural America. An Emory University survey shows rural areas see nearly twice the Alzheimer’s death rate of urban regions. And a University of Iowa study found agricultural workers are almost 50% more likely to develop the disease. One of the major contributors to this is thought to be the lack of access in much of rural America to health care professionals who have experience in treating Alzheimer’s and related dementias.

After decades of failed trials, new treatments promise to slow progression of Alzheimer’s by removing amyloid plaques, a telltale sign of the disease, from the brain. The problem is that Medicare is severely restricting coverage for these treatments, and for the diagnostic brain scans needed to use them. If a Medicare beneficiary wants the program to cover the cost of care, he or she will have to enroll in one of a select few clinical studies. And where are these studies held? You guessed it: at health care institutions in major population centers.

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.

Fortunately, expanding Alzheimer’s coverage has bipartisan support in Congress. 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.