Higher uninsured rates among rural compared to urban residents have been well documented, but do not adequately provide a full picture of coverage and access to care in rural areas. This study looks at the relative richness of coverage among privately insured rural residents, to determine their rate of ?underinsurance? and whether and how it differs from urban residents. The authors found that even with private health insurance coverage, a sizable portion of out-of-pocket costs is borne by the insured, particularly rural residents. Six percent of privately insured urban residents are underinsured compared with 10 percent of rural adjacent and 12 percent of rural nonadjacent residents. Policy implications for coverage expansion, for providers, and for small businesses are discussed.
Cutler Institute for Health and Social Policy
Out-of-Pocket Health Spending and the Rural Underinsured
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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.