Medicaid Is a Vital Safety Net for Rural Communities

For the millions of Americans living in rural communities across the country, Medicaid provides an essential source of high-quality, affordable health coverage. Nearly a quarter of nonelderly individuals living in rural areas are covered by Medicaid, and these individuals rely on the program for access to primary care and other critical health services.

Rural Residents Face Significant Health Disparities

Rural residents often face significant barriers to care, exacerbating health disparities in these communities.

On average, rural residents have lower incomes and higher overall poverty rates than urban residents. Further, individuals in rural communities are more likely to be uninsured than urban and suburban residents.

Individuals living in rural areas report poorer physical and mental health and have higher rates of obesity than urban residents. Among the leading causes of death in the United States — heart disease, cancer, chronic respiratory disease, and stroke — mortality rates are comparatively higher in rural areas. Rural individuals are also more likely to die by suicide or from a drug overdose.

The Vital Role of Medicaid in Rural Areas

Medicaid expansion under the Affordable Care Act has only reinforced Medicaid’s vital role, driving major health and wellness gains for rural America. In states that have adopted Medicaid expansion, rural areas have experienced larger coverage gains than rural areas in non-expansion states. Additionally, Medicaid expansion has helped stabilize rural hospitals’ finances, preventing hospital closures that would further restrict health care access for vulnerable Americans.

All told, nearly 16 million people have gained health coverage through Medicaid expansion as of July 2020. Further, studies have found that increases in Medicaid coverage have not been offset by a decrease in private insurance, which means Medicaid is effectively reaching the previously uninsured. While these coverage gains are impressive, there is an opportunity to do more. If the states that have not yet expanded Medicaid were to do so, the Department of Health and Human Services estimates that an additional 4 million people would become eligible for Medicaid.

Further, expanding Medicaid coverage has been proven to stimulate state economies where it has been implemented. One study found that additional federal Medicaid spending during the Great Recession (2007-2009) increased state employment in many sectors, helping to offset the impact of the economic downturn.

Medicaid Provides Affordable, High-Quality Care

Medicaid provides more than just basic health care access. The program provides high-quality health coverage with a broad range of benefits.

People with Medicaid coverage have access to a regular health care provider at rates comparable to people with private coverage. Further, Medicaid enrollees are more likely than uninsured individuals to say that their care was excellent or very good. Medicaid enrollees are also less likely to have trouble paying for care or skip important services due to cost than uninsured individuals.

Medicaid is also leveraging telehealth to help further eliminate barriers to care for rural communities. By virtually connecting enrollees to their health care providers, telehealth is expanding access to vital services, including primary care, physical and occupational therapy, mental health support, and maternity care. Studies have shown that Medicaid enrollees in rural areas are up to 17 times more likely to use telehealth compared to urban residents.

While COVID-19 has further stressed the rural health landscape, Medicaid continues to serve as a vital safety net and provide critical health services for the most vulnerable.