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Report Finds Rural Medicaid Disadvantage

PHOTO: The Center for Rural Affairs found rural states were less likely than urban states to accept federal Medicaid money under ACA. Photo credit: NIH
PHOTO: The Center for Rural Affairs found rural states were less likely than urban states to accept federal Medicaid money under ACA. Photo credit: NIH
December 23, 2013

CASPER, Wyo. - Today is the deadline for applying for insurance under the Affordable Care Act. Because Wyoming did not accept federal Medicaid funding, thousands have fallen into what is being called the "Medicaid gap."

Jon Bailey, director of rural policy, Center for Rural Affairs, researched who is affected and found that rural states were less likely to accept the federal money. The refusal means no insurance for about 17,000 Wyomingites, he said.

"This gap is bringing in a lot more people than you would think, and a lot of different kinds of people - a lot of people who really need health insurance and people who really deserve some help from the government," Bailey said.

Nationwide, Bailey found that 1.8 million rural and small-town people fall into the coverage gap in states that have rejected Medicaid funding. They make too much money to qualify for state Medicaid standards, and they don't earn enough to qualify for subsidies to purchase insurance thorough the health exchange.

Another note that Bailey found interesting is that the percentage of Americans affected by the Medicaid gap is about the same as the number who were told by insurers that their insurance policies would be canceled because they didn't comply with federal law. That situation had a very different ending - after what Bailey called "constant media coverage." Those policies were allowed to stand, he said.

"We moved heaven and earth for that group of people," Bailey said. "Now, we have these 1.8 million rural people who don't have any options for health insurance, and very little is being done for them."

Additional Medicaid funding was part of the Affordable Care Act. A U.S. Supreme Court ruling made it optional for states to accept the funding. Just over half have accepted it - with Arkansas and Arizona being among the latest.

The report, "Medicaid Expansion as a Rural Issue: Rural and Urban States and the Expansion Decision," is available at http://files.cfra.org.

Deborah Courson Smith/Deb Courson Smith, Public News Service - WY