Health insurance plans under the Affordable Care Act went into effect Jan. 1, and after a rocky start in the enrollment process, people await to see the effects Obamacare will have in the country's 46 million uninsured, as well as its medical professionals and facilities.

More than one million Arizonans don't have health coverage, and experts say many of them are found in the state's rural cities, where non-existent insurance isn't the only issue, but also the lack of broad medical equipment, doctors and services.

Dr. Daniel Derksen portrait

Photo: AZPM Staff

Dr. Daniel Derksen, professor at UA's Mel and Enid Zuckerman College of Public Health, and director of the Center for Rural Health.

As the exchange rolls out, there continues to be a split debate whether the new law will truly make permanent positive changes in these areas and the entire health care system, or if it's merely a temporary fix that will eventually fail.

Health care experts in Southern Arizona explored these possibilities during Friday's broadcast of Arizona Week.

"There are two challenges that are difficult to overcome when it comes to accessing health care in rural America," said Dr. Daniel Derksen, a professor at the UA's Mel and Enid Zuckerman College of Public Health. "About 75 percent of Arizona's population lives in two metropolitan areas, Phoenix and Tucson...and about 86 percent of physicians practice in these two cities. So, just about every other community outside of those...have challenges with nursing...dental...medical...services."

ACA has some provisions that would help distribute medical work force to these areas.

The provisions establish funding for medical training to move closer to rural towns, and also provide incentives for medical professionals who choose to practice in these small communities, explained Derksen, who helped write the health work force provisions.

Jim Dickson, CEO of Copper Queen Community Hospital in Bisbee, and Dean French, CEO of Sierra Vista Regional Health Center in Sierra Vista, say they haven't seen any of these alleged upcoming fixes. However, as French puts it, it's merely a little more than a week into the rollout, and it is too early to feel any changes.

"We are not seeing any direct effects at this time in Sierra Vista," he said. But the health center is recruiting 20 physicians over the next 15 months, "so that we can broaden the scope of our services."

Jim Dickson portrait

Photo: AZPM Staff

Jim Dickson, CEO of Copper Queen Community Hospital in Bisbee, Ariz.

Dr. Dean French

Photo: AZPM Staff

Dr. Dean French, CEO of Sierra Vista Regional Health Center in Sierra Vista, Ariz.

Dickson said he doesn't think ACA will bring any extra equipment or doctors to his region. And, since his hospital already treats uninsured patients, the fact that many of them will be able to sign up for coverage doesn't really make a difference.

"I don't think it (ACA) is going to help in rural America, it might in metro America," he said. The federal government is hoping the law will function as "one size fits all," but it needs to vary according to the market and community that it's in, he explained.

To Derksen and French, ACA puts the state in a good path, where millions of people will be able take care of themselves, and not wait until the last minute to treat illnesses because they're unable to afford preventive care.

"We can't ignore that we have some challenges to overcome, and with ACA (we have the tools and opportunities) to address those long-standing health disparities," Derksen said. "(Also), for the first time now, rural areas with have choices."

Glitches should be expected, but the outcome will be positive, he added.