A report from the Center for Rural Affairs shows a major difference between urban and rural residents on whether they would expand Medicaid under the Affordable Care Act. Jon Bailey, the center’s rural public policy program director, says about half the states in the country have expanded their Medicaid coverage under the ACA.
Bailey says their study shows most of that expansion has happened in urban states. “There seems to be some correlation between whether a state is primarily rural and primarily urban and their decision on the Medicaid expansion,” Bailey says. “With rural states, the states with the highest rural populations, deciding not to expand and the states with the highest urban populations deciding to expand.”
Iowa’s plan is unique. The state will offer health care coverage to as many as 150-thousand uninsured Iowans, many of whom will get subsidies to buy private insurance. It requires a small monthly premium payment from those who fail to have yearly check-ups or follow a doctor’s orders to quit smoking or make other healthy lifestyle choices. The federal government granted Iowa a waiver for the plan in December, but it forbids state officials from kicking people out of the program if they fail to pay the premium.
Bailey says in many of the rural states, there is a large group of low-income people who are not covered by health insurance who would be covered if Medicaid were expanded. “There’s going to be a lot of rural people who could qualify for this expansion,” he says. “Some of the presentations we’ve done throughout the Great Plains on the Affordable Care Act have borne that out. A lot of the people who come to our meetings find out they’re in this gap.”
Bailey says they are also finding many people in those rural states losing the insurance coverage they currently have. Bailey says, “The last month or so, it’s been non-stop, 24-7 news about these people having their insurance canceled, having to find other insurance.” He says they believe the best solution is for states to expand their Medicaid coverage under the Affordable Care Act. The Center for Rural Affairs is based in Lyons, Nebraska.
By Jerry Oster, WNAX, Yankton
