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Study: Rural Idaho Left Behind Other States Where Medicaid Expanded

The uninsured rate for children has dropped twice as fast in states that expanded Medicaid, compared with those that didn't. (darby/Twenty20)
The uninsured rate for children has dropped twice as fast in states that expanded Medicaid, compared with those that didn't. (darby/Twenty20)
September 26, 2018

BOISE, Idaho - States that expanded Medicaid have seen the number of uninsured adults in rural communities drop three times faster than in states such as Idaho that opted not to expand coverage, according to a new report from the Georgetown University Center for Children and Families.

Lauren Necochea, director of Idaho Voices for Children, said expansion has helped children as well. When parents have a coverage option, she said, children are more likely to be insured.

"The report shows this," she said. "Expansion states have seen almost double the rate of decline of uninsured children when compared to non-expansion states. Medicaid expansion is a huge opportunity to get more children covered and to increase coverage rates in rural areas."

Prior to the Affordable Care Act in 2009, the uninsured rate for Idahoans in rural areas and small towns was 38 percent, the report showed. In 2016, it was 28 percent. In comparison, the number of uninsured rural Nevadans dropped from 42 percent to 14 percent. Nevada expanded Medicaid in 2014.

The study's co-author, Joan Alker, executive director of the Georgetown center, said strong health centers are critical for rural communities, not only because of the care they provide but also because they're frequently the largest employers in small towns. She said expanding coverage to more residents in rural areas, where unemployment and poverty rates are higher, makes economic sense.

"When there's a real option here on the table to take these Medicaid dollars," she said, "really, it's a wiser use of taxpayer dollars to provide them with the primary preventive care that comes with having health insurance up front, so they don't get sicker and wind up in the emergency room."

In November, Idahoans will have a chance to weigh in on this issue. Voters will decide on Proposition 2, an initiative that will expand Medicaid coverage in the Gem State if it passes.

The report is online at

Eric Tegethoff, Public News Service - ID