Cutler Institute for Health and Social Policy

Population Health and Health Policy

Expanding Rural Health Insurance Coverage: How Do Insurance Reform Strategies Stack Up?

Duration: 
1/1/2007 - 1/31/2008
Principal Investigator: 
David Hartley, Ph.D., M.H.A.
Abstract: 

<p>There is renewed interest in health insurance reform at both the state and federal level due to the continuing erosion of private insurance coverage and continuing increases in the number of uninsured. The purpose of this study is to inform policymakers about the current state of health insurance coverage in rural America, and to identify how specific reform strategies may differentially affect rural residents.</p>

<p>Using a combination of analytic strategies, including literature review, secondary data analyses, eligibility simulation models, and policy analyses, we will provide policymakers and rural health advocates with the necessary tools to develop reform strategies that meet the needs of rural residents. We seek to address the following research questions: 1)What does a comprehensive review of the literature and research synthesis reveal about rural-urban differences in health insurance coverage, the factors associated with these differences and how economic and/or policy changes affect these differences? 2) What is the current (as of 2005) status of health insurance coverage among rural residents, and how does this differ by region, socioeconomic status and degree of rurality? and, 3) What are the implications for rural residents of specific features of health insurance reform proposals under consideration at the time of analysis?</p>

Start Date: 
Mon, 2007-01-01
End Date: 
Thu, 2008-01-31
Legacy Muskie ID: 
5 087

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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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