Since the introduction of Medically Underserved Areas (MUA) program in 1978, the U.S. government used the program to identify communities in the U.S. with substantial barriers to obtaining regular access to health care.  Albeit an important program in allocating public funds meant to increase access to care among low income and uninsured groups, the causal effects of MUA designation have not been rigorously evaluated in the literature.  With emphasis on the effects of designating rural non-metropolitan counties, I employ a Fuzzy Regression – Discontinuity research design to identify plausible treatment effects of MUA designation on 1) the presence of federally – funded Community Health Centers (CHC) and 2) long term increases in access to care.  Counties designated as underserved in the initial program year have more opportunity to accumulate resources to support health care safety net activities thereby facilitating improvements in access to care.  Preliminary lower bound estimates from the instrumental variable regressions indicate positive effects of meaningful MUA designation on increased prevalence of CHCs in designated counties in 1985 – 1990 suggesting a higher availability of low cost care for persons likely to rely on the safety net for care.