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Health of Rural Economies, People Affected by Coverage Gap

The closure of rural hospitals in nine Tennessee communities can make it more difficult for those areas to attract new, well-paying employers. (stopnlook/Flickr)
The closure of rural hospitals in nine Tennessee communities can make it more difficult for those areas to attract new, well-paying employers. (stopnlook/Flickr)
September 27, 2018

CHAPEL HILL, N.C. – North Carolina's rural communities are paying the price for the state's decision not to expand Medicaid, according to a new report by the North Carolina Rural Health Research Program and the Georgetown University Center for Children and Families.

The report says states that expanded Medicaid saw more than three times the rate of decline in the uninsured adult population in rural areas.

Beyond that, John Coggin, director of advocacy for the NC Rural Center, says the economies in those communities are also impacted.

"One of the foundations of a healthy rural economy is a healthy rural health sector,” he points out. “It's important to make sure we have a healthy workforce, but the jobs the health sector provides are also good paying jobs. "

Prior to the Affordable Care Act, rural parts of North Carolina had a 35 percent rate of uninsured people, and that currently sits at 29 percent.

Comparatively, Arkansas, which did expand Medicaid, saw its uninsured rate drop from 45 percent to 22 percent.

Some states haven't expanded Medicaid because they fear being stuck with the costs if the federal government pulls out.

But study co-author Joan executive director of the Georgetown University Center for Children and Families, maintains states like North Carolina should expand, nonetheless.

"And this is sort of the fundamental issue with keeping folks uninsured when there's a real option here on the table to take these Medicaid dollars,” she states. “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."

So far, at least five rural hospitals have closed in the state since 2010, which Coggins says affects the quality and availability of care for everyone.

"That is money that not only would help hospitals pay for their current costs, but help them be in a stronger position to recruit more doctors and physicians, expand their services and create a better health sector for all people," he states.

According to the report, one-fourth of the people without coverage are also parents. Other studies indicate that when parents lack coverage, it also impacts their children's health and well-being.

Stephanie Carson, Public News Service - NC