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Medicaid Coverage in Metro and Small Town/Rural Counties, 2020-2021

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Medicaid’s Coverage Role in Small Towns and Rural Areas – Center For Children and Families (georgetown.edu) First time, I have done an interactive chart. I have to figure out how to enlarge the chart. I will figure it out in time. Enjoy for now and maybe you can find where you live on the small map. If you go to Georgetown Center for Children and Families site, you will get a better map perspective. As the title says this is for Metro, towns, and rural areas (counties) covering children and non-elderly adults. Once you find your state, you can blow it up a bit (within the limits of the present picture) to find the exact county, etc. [embedded content] Medicaid’s vital role as an insurer for low-income families, people with

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Medicaid’s Coverage Role in Small Towns and Rural Areas – Center For Children and Families (georgetown.edu)

First time, I have done an interactive chart. I have to figure out how to enlarge the chart. I will figure it out in time. Enjoy for now and maybe you can find where you live on the small map. If you go to Georgetown Center for Children and Families site, you will get a better map perspective.

As the title says this is for Metro, towns, and rural areas (counties) covering children and non-elderly adults. Once you find your state, you can blow it up a bit (within the limits of the present picture) to find the exact county, etc.

Medicaid’s vital role as an insurer for low-income families, people with disabilities and chronic health conditions, and individuals in need of long-term services and supports in the nation’s health care system has continued to grow over the past decade. According to federal administrative enrollment data, one-quarter of all residents of the United States and more than half of all children — nearly 94 million people — were covered by Medicaid and the Children’s Health Insurance Program (CHIP) as of March 2023.

This is especially the case in rural areas where residents are less likely to have jobs with health coverage and more likely to be uninsured or underinsured.  They also face numerous challenges in accessing needed health care. People living in rural areas  travel  further for appointments and are more likely to miss out on needed health care because of trouble finding transportation, while lower rates of internet connectivity can limit access to telehealth services and make it harder to comply with state administrative renewal requirements. Children in rural areas in particular are less likely than children in urban areas to have had a checkup and a dentist visit in the past year. And in addition to the stress uninsurance places on a family, higher uninsured rates in rural areas can strain  hospital finances by increasing the share of uncompensated care, and rural hospital closures can contribute to even more serious provider shortages. Rural counties also tend to have higher poverty rates, so families in these areas are more likely to qualify for Medicaid/CHIP. Medicaid can be a lifeline amidst these challenges by helping to provide states, hospitals, and providers with resources they need to deliver care and by making sure that enrollees have the affordable and comprehensive coverage they need to see doctors, fill prescriptions, and manage chronic conditions.

States are currently facing the historic challenge of redetermining Medicaid eligibility for all beneficiaries as part of the unwinding process. While some beneficiaries will lose their Medicaid coverage because they are no longer eligible, many others, including children, will end up disenrolled for procedural reasons even though they remain eligible. Early data from states’ unwinding processes have already found high rates of procedural disenrollments and also Medicaid enrollment declines among children —in many places. This will pose a dire risk to small towns and rural areas, threatening coverage and access for low-income residents and threatening the viability of rural health systems.

Medicaid’s Importance for Rural Areas Has Grown

As of 2020-2021, Medicaid/CHIP provided coverage for a larger share of both adults and children in small towns and rural areas than in metropolitan counties nationwide and in every state examined.  This disparity was even wider for children. Among children, Medicaid and CHIP covered 47% of children in rural areas compared to 40% in metro counties. See Figure 1. This is a 2-percentage point increase from the share of children covered by Medicaid/CHIP in both small towns and rural areas (45%) and metro counties (38%) in 2014-2015.

Adults in rural counties also relied on Medicaid/CHIP more than adults in urban counties, with 18% covered by Medicaid/CHIP compared to 15% of adults covered in metro counties. (Figure 1.) Medicaid and CHIP coverage among adults has also increased in rural areas, from 16% covered in 2014-2015, while coverage in metro counties has held steady.

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