Health care top of mind for rural Wisconsin voters this presidential election

Rural Wisconsin’s access to health care has been shrinking in recent years. Hospitals have closed, clinics have shuttered or limited services, and many miles have been put between residents and reproductive care.

And with just a few weeks until the presidential election, health care has become one of the leading issues of the race for voters in these communities, but one that they wish the rest of the state cared about more.

A recent statewide Marquette Law School poll revealed that registered Wisconsin voters rank health care as a low-priority issue, with only 5% of them selecting it as the issue they cared about most. Nine percent chose Medicare and Social Security and 15% chose abortion policy as the top issue they’re voting on. 

Kathleen Rulka, a Marshfield resident and the co-chair of the Wood County Democrats, said those issues are “truly matters of life and death.”

There is a lot of daylight between Harris’ and former President Donald Trump’s plans for health care.

Trump wants to repeal the Affordable Care Act, also known as Obamacare, but has yet to reveal a plan to replace it. He’s also said he’s open to making cuts to Medicare, which provides insurance to people 65 or older, and has taken credit for overturning Roe v. Wade.

Harris wants to build on the ACA by permanently adopting tax credits that lower health care premium costs and continuing to lower the cost of prescription drugs such as insulin. The Biden-Harris administration introduced those credits in 2021, but they’re set to expire at the end of 2025. Harris has also promised to sign federal legislation codifying abortion rights if such a law is passed by Congress.

Residents in Marshfield, a small central Wisconsin city of about 19,000 people, have gotten a front row seat to the decline in health care access in rural Wisconsin.

The city is home to the Marshfield Clinic, one of the region’s leading health care systems, which has more than 60 clinics and 11 hospitals across Wisconsin and Michigan’s Upper Peninsula. In recent years, the health care system has closed locations and limited specialty practices such as urgent care and labor and delivery services. In April, Marshfield Clinic announced it was laying off 3% of its staff.

Meanwhile, the clinics and staff that remain are absorbing more patients as other hospitals and health systems close. The Marshfield Medical Center in Eau Claire reported a 47% increase in ER patients and a 160% increase in deliveries after two hospitals closed in the Eau Claire area last spring.

It’s an issue that Marshfield resident Frank Pyles doesn’t think gets enough attention across the state, even though it’s felt acutely by rural residents.

Closures of clinics and disappearing access to health care in rural Wisconsin are just one piece of a compounding issue. The future of the Affordable Care Act is another.

The ACA, which was passed in 2010, expanded access to affordable medical insurance and barred insurance companies from denying coverage because a person had a preexisting condition. In 2024, at least 266,000 Wisconsin residents enrolled in insurance under the ACA.

When Pyles and his wife lived in Canada, insurance covered open heart surgery for her in 1985 and a second surgery in 2005.

But when they moved to Marshfield in 2018, it opened their eyes to the lack of affordable care in the United States. Had they lived in the U.S. at the time of his wife’s surgeries, they would have struggled to find an insurance company that would have covered the procedures. And there’s still a chance she could need a third surgery, putting access to health insurance front and center for them.

“I know that for many, that provision and others, such as allowing young adults to remain on their parents’ plan until age 25, and many other provisions have taken away a great deal of anxiety, and for many, it saved their life,” Pyles said, speaking at an event hosted by the Harris-Walz campaign in Marshfield.

Before the ACA was passed, Rulka’s friend Savannah struggled to find treatment for pancreatic cancer. She said she visited three different health care facilities before anyone would schedule her for an appointment.

A retired marriage and family therapist and clinical chaplain who specialized in end-of-life care and trauma care, Rulka is now the co-chair of the Wood County Democrats. She’s lived in Marshfield since 2007.

“I saw how important health insurance was, that it could save people’s lives, as well as make their last days easier for them and their families,” Rulka said at the event.

Access to obstetric care for rural Wisconsinites is becoming more limited, too, as clinics and hospitals close their doors or shrink their services. “It’s really a problem. There’s just miles to travel,” Pyles told the Wisconsin Independent.

Both of the Marshfield residents said the issue of health care touches everyone, even if they haven’t personally experienced an issue with access or affordability.

“We don’t always have a personal story, but we have relationships that expand beyond our personal story, and those relationships inform us that we must care about our loved ones, about our neighbors, about our community, and step up and be a voice for all the people that we live in relationship with,” Rulka said.