If there is one thing I have learned most certainly in my career working to raise quality and lower cost of health care, it is that people don’t stop getting sick or injured just because they don’t have insurance. For both rural hospitals and Level 1 Trauma centers this poses particularly challenging consequences. They are left with the bills of the uninsured and underinsured. This has caused a real crisis for rural and safety net hospitals. I joined my fellow citizens in breathing a collective sigh of relief with every failed repeal effort that would drive the percentage of uninsured up.