Cutler Institute for Health and Social Policy

Maine Rural Health Research Center

High Deductible Health Insurance Plans in Rural Areas

Abstract: 

Enrollment in high deductible health plans (HDHPs) has increased amid concerns about growing health care costs to patients, employers, and insurers. Prior research indicates that rural individuals are more likely than their urban counterparts to face high out-of-pocket health care costs relative to income, despite coverage through private health insurance, a difference related both to the lower income of rural residents generally and to the quality of the private plans through which they have coverage. Using the 2007-2010 National Health Interview Survey, this study examines rural residents’ enrollment in HDHPs and the implications for evolving Affordable Care Act Health Insurance Marketplaces.

Rural residents with private insurance are more likely to have an HDHP than are urban, especially when they live in remote, rural areas. Among those covered by an HDHP, rural residents are more likely to have low incomes and more limited educational attainment than urban residents, suggesting that it will be important to monitor HDHP enrollment, plan affordability, and health plan literacy among plans available through the Health Insurance Marketplaces.

Associated Research & Policy Brief: Rural Residents More Likely to be Enrolled in High Deductible Health Plans

Suggested Citation: Lenardson JD, Ziller EC, Coburn AF. High Deductible Health Insurance Plans in Rural Areas. Portland, ME: University of Southern Maine, Muskie School of Public Service, Maine Rural Health Research Center; May, 2014. Working Paper #55.

Publication Type: 
Report
Publish Date: 
May 13, 2014
URL: 
http://muskie.usm.maine.edu/Publications/rural/High-Deductible-Insurance-Plans-Rural.pdf

Cutler Institute awarded $600,000 to help youth raised in foster system

Marty Zanghi

USM's Cutler Institute for Health and Social Policy has been awarded a $600,000 grant to help young people raised in Maine's foster system to prepare for college and the workforce.

The money comes from the Annie E. Casey Foundation as part of a $5.4 million national effort aimed at youth who are homeless or in either the foster care or juvenile justice systems.

"Many of these young people have suffered abuse or trauma and were raised in poverty and neglect," said Marty Zanghi, the Cutler Center's youth development director.

The money -- including an expected $400,000 more in matching funds -- will pay for contracted work with agencies in the target areas, starting with the greater Portland area and Penobscot, Kennebec and Somerset counties.

Nationally and in Maine, only about 3 percent of people who grow up in the foster care system achieve a college degree, he said.

"It's dramatically lower than the rate for the general population," Zanghi said. "It's a horrible outcome."

It doesn't have to be that way, though.

"There are young people that overcome these circumstances," he said. "I know people who have master's degrees and Ph.Ds."

The Casey Foundation's national effort is being called the "Learn and Earn to Achieve Potential" (LEAP) initiative.

The initiative is working on partnerships in Maine and nine other areas: Alaska, Arizona, California, Massachusetts, Michigan, Minnesota, Nebraska and New York. In each case, people will adapt two evidence-based models to meet the needs of these youth, including support to address the trauma they may have experienced in their lives.

In Maine, the work will include a pair of successful programs, Jobs for Maine Graduates (JMG) and Jobs for the Future. Results will be carefully tracked, Zanghi said.

After the first year, the program is expected to grow.

"Eventually, the additional help will be available to all children, 14 and over, in the foster care system in the state of Maine," Zanghi said.

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