Cutler Institute for Health and Social Policy

Population Health and Health Policy

Health Insurance Dynamics of Uninsured Rural Families

1/1/2004 - 1/31/2005
Principal Investigator: 
Andrew Coburn

Numerous studies have found higher uninsured rates among rural versus urban residents, yet our understanding of the health insurance coverage of rural families remains limited. This is because the previous studies have focused on the insurance status of rural individuals despite growing recognition among researchers and policymakers that health insurance is what the Institute of Medicine (IOM) calls "A Family Matter" (IOM 202).

To better understand the dynamics of insurance coverage among rural and urban families, this study will use the Medical Expenditure Panel Survey (MEPS) to compare family health insurance coverage among non-elderly rural and urban families. This study has three objectives: 1) In households with at least one uninsured member, to determine if there are rural-urban differences in family-level insurance status (fully insured, partially insured, or completely uninsured; 2) Among families with mixed coverage, to identify the insurance status of other family members (Medicare, Medicaid, employer-sponsored, and non-group private); and, 3) To determine what employment and socioeconomic characteristics are associated with rural families health insurance mix and whether these characteristics are the same or different than for urban families.

Given that current strategies to address the uninsured appear to be focused almost exclusively on incremental health insurance reform, the findings from this study will assist policy-makers in determining how to build on existing insurance systems in ways that will be most effective for rural families.

Start Date: 
Thu, 2004-01-01
End Date: 
Mon, 2005-01-31
Legacy Muskie ID: 
2 147

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Dr. Ziller to speak on Rural Implementation and Impact of Medicaid Expansions

The impact of the ACA Medicaid expansion on health care coverage and access in rural areas is largely unknown and will depend on the different state policy contexts in which the expansions are implemented and on existing system capacity. Understanding how many rural residents are likely to become newly eligible for Medicaid under the ACA, as well as their characteristics and health status, will provide important information to aid policymakers in structuring outreach and enrollment strategies and ensuring that the healthcare infrastructure and delivery systems in rural areas can address the needs of these individuals.

On March 18th, Dr. Ziller, Deputy Director of the Maine Rural Health Research Center at the University of Southern Maine, will present via a SHARE webinar, nationally representative information identifying rural-urban differences among low-income non-elderly adults (18 to 65) in the following areas:

  • Medicaid eligibility, pre-ACA
  • Medicaid participation, pre-ACA
  • New Medicaid eligibility in 2014

Dr. Ziller will also analyze the characteristics associated with any rural-urban differences in the above areas. Characteristics to be considered include age, gender, employment, education, income, Census region, health status, current relationship to primary care provider, primary care supply, and FQHC availability.

This webinar is based on Dr. Ziller's research under a State Health Access Reform Evaluation (SHARE) grant to inform federal and state implementation of the ACA Medicaid expansion by estimating the size and characteristics of the rural population likely to be newly eligible.
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