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SD's Low-income Residents Have Nation's Highest Uninsured Rates

Rural residents across America rely on Medicaid to get health coverage, at the same time Medicaid helps rural hospitals keep their doors open and provide health care and jobs. (evolutionnews.org)
Rural residents across America rely on Medicaid to get health coverage, at the same time Medicaid helps rural hospitals keep their doors open and provide health care and jobs. (evolutionnews.org)
September 26, 2018

SIOUX FALLS, S.D. - South Dakota is not one of 33 states that expanded its Medicaid program under the Affordable Care Act, but a new report contends that if it had done so, more rural low-income residents would be covered by health insurance.

The report from Georgetown University showed that states without expanded Medicaid have big coverage gaps. Study co-author Joan Alker, executive director of Georgetown's Center for Children and Families, said the uninsured rate for low-income adults has dropped since about 2008 in nearly all states, but the sharpest declines were seen in small towns and rural areas in states that have expanded Medicaid.

"The major finding," she said, "is that states that expanded Medicaid saw more than three times the rate of decline in the uninsured adult population in rural areas and small towns than those that did not expand Medicaid under the Affordable Care Act."

Alker noted that South Dakota was among a handful of states that had the nation's highest rate of uninsured low-income adults in small towns and rural areas.

She said rural areas typically have fewer high-paying jobs that offer employees health insurance, leading to higher poverty rates that burden struggling communities. Based on statistics from other states, Alker said South Dakota's rate of low-income uninsured residents would likely be cut in half if Medicaid were expanded.

"Our report found that the uninsured rate for low-income adults in South Dakota in rural areas is a whopping 47 percent," she said. "So almost one in two of these folks are uninsured as compared to 41 percent in metro areas."

About 2.2 million poor adults live in non-expansion states, which makes them ineligible for either Medicaid or subsidized Marketplace insurance coverage under current law.

The report is online at georgetown.edu.

Roz Brown, Public News Service - SD