Medicaid – A Lifeline for Rural America
As we continue to celebrate Medicaid Awareness Month – an initiative led by Protect Our Care – to highlight the value of Medicaid, we turn our attention to the vital role of Medicaid for rural communities.
Recent events remind us that Medicaid remains under attack at all levels of government and across the country. Yet at the same time, state and national polls demonstrate an increasingly positive public perception of the Medicaid program. A poll from last week demonstrates the popularity of Medicaid expansion in Louisiana, and another recent report shows that people in rural Kansas are largely pro-expansion.
Medicaid expansion is a time-tested and proven solution for many of the unique struggles facing rural communities throughout our country. Therefore, we as advocates must highlight the many ways that Medicaid might act as the solution and revitalize commitment to its expansion in times of hardship.
Medicaid acts as a solution for the problems faced by rural America in the following ways:
Medicaid can address rural America’s health disparities by providing greater access to care
For both adults and children living in rural communities, health care is significantly more difficult to access than in urban and suburban areas. This lack of access can be attributed to social determinants such as lower household incomes, lower rates of employment, higher rates of disability, and less access to health networks and health care providers. Simply put, poor health and more joblessness results in less money and fewer employer-sponsored health benefits for individuals who are not yet eligible for Medicare. This affects more than just adults. In fact, in 2016, over 3.3 million rural children grew up in poverty, and therefore with less coverage.
Medicaid improves access to care by bridging this coverage gap. Although all states have seen a decrease in uninsurance rates for low-income adults since 2008, small towns and rural areas that expanded Medicaid access have experienced the most positive change. For rural residents in expansion states, uninsurance rates have dropped from 35 percent to just 16 percent in this time. In contrast, non-expansion states have only seen rates drop from 38 percent to 32 percent.
Medicaid prevents hospital closures
In rural America, hospitals are becoming fewer and farther between. Since 2010, nearly 100 rural hospitals have closed, and over 600 others may soon face the same fate. These closures can be attributed to the significant volume of uncompensated care that high uninsurance rates cause in patient populations.
That said, research from the University of Colorado shows the Affordable Care Act’s expansion of Medicaid can be tied to significant reductions in the probability of hospital closures. Due to Medicaid’s improved coverage of rural Americans, rural hospitals in these states are more likely to receive compensation, allowing them to keep their doors open and continue providing care to those who need it.
To learn more about hospital closures, read our Health Policy Hub post ‘The Hits Keep on Coming – Medicaid Expansion Helps Rural Hospital Stay Open’.
Medicaid boosts rural economies
To this day, rural communities struggle to rebuild after the 2008 financial crisis. Take one example, for those living in rural Perry County in Tennessee, 22 percent live in poverty. This is not due to a lack of motivation to work, as some politicians would like to believe; instead it is a lack of highway infrastructure in rural areas that dissuades the creation of new jobs. One reason Perry County’s economy is poor is the lack of good-paying-jobs. Gaining employment means residents need to travel nearly 140 miles to Nashville or Memphis, in cars many residents may not be able to afford, for work they may not be healthy enough to perform.
In the face of joblessness, Medicaid again provides a solution. Medicaid not only affords insurance to low-income residents and protects them from high out-of-pocket costs and copays, but it also creates jobs. This has already been proven through federal and state Medicaid funding that help to keep rural hospitals open. Rural health care jobs account for 14 percent of total employment, and this line of work often pays more than other employment opportunities in the area. It is easy to see, then, how the maintenance of rural hospitals can energize a rural community through job creation, tax revenues, and secondary job creation. When a rural hospital thrives, a community thrives.
Medicaid matters for individuals
Access to health care means more than just a bottom line. At the end of the day, Medicaid matters not for its cost-effectiveness, but for its ability to uphold an individual’s dignity at what may be a vulnerable time. For many rural Americans, Medicaid enables them to work, to be a parent, to get and stay healthy, and, in some cases to stay alive.
For the woman who has lost her job, Medicaid means she may still receive preventive care like regular screenings, vaccinations, and visits to the doctor.
For the man whose disability requires long-term care, Medicaid means he does not have to wait until he is over 65 to get the support he deserves.
For low-income people, Medicaid means they are protected from costly out-of-pocket expenses and co-pays.
Like anyone else, rural Americans deserve the ability to receive care without having to sacrifice their finances, lifestyles or values. Medicaid affords people this dignity.
Medicaid is a lifeline for rural communities. Advocates must continue energizing these communities and fighting for expansion in states that have withheld. To learn more about how you can help engage rural constituencies, please read our strategic guide.
Guest Blogger: Bridget Gautrau is an intern with the Community Catalyst communications department and a student at Northeastern University in Boston, MA.