Cutler Institute for Health and Social Policy

Population Health and Health Policy

Rural Residents More Likely to be Underinsured (Policy Brief)

Abstract: 

The purpose of this study was to identify whether and to what extent there are rural-urban differences in underinsured rates among the privately insured, and, where differences exist, to understand what characteristics of rural residents are related to their likelihood of being underinsured. Using the 2001 and 2001 Medical Expenditure Panel Survey (MEPS), the authors examined the annual out-of-pocket health care expenditures for U.S. residents under age 65 that were continuously insured by a private plan in either 2001 or 2002.<p></p>Findings showed that, despite having private health insurance coverage, those who use medical services continue to pay for a substantial portion of their own health care costs, particularly those living in rural areas. The average rural non-adjacent individual paid for 39% of their care in 2001 or 2002, compared to 35% for rural adjacent and 32% for urban individuals. Additional findings showed that one out of eight non-adjacent residents is underinsured (12.4%), compared to 10% of rural adjacent and 7% of urban residents.

Publication Type: 
Research and Policy Brief
Publish Date: 
February 1, 2006
Author: 
URL: 
http://www.muskie.usm.maine.edu/Publications/rural/PB33.pdf

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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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