Thomson ReutersThe health of rural America is failing, and a repeal of the Affordable Care Act (ACA) without adequate replacement could prove disastrous. A December, 2016 report from the Centers for Disease Control and Prevention showed that for the first time in 20 years, life expectancy in the United States has declined, particularly in small cities and rural areas, where people are dying at much higher rates. This shocking trend is driven in part by increasing mortality rates for white, working-class Americans, many of whom live in rural America. There is no better indicator of well-being than life expectancy, and reversals like this are unusual for wealthy nations where successive generations increase in longevity.