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Rural Utah Could See Biggest Gains Under Medicaid Expansion

Adults living in rural areas are projected to benefit most if Utah expands access to Medicaid. (Vongan/Twenty20)
Adults living in rural areas are projected to benefit most if Utah expands access to Medicaid. (Vongan/Twenty20)
October 3, 2018

SALT LAKE CITY - The rate of people without health insurance in rural Utah communities is far higher than the rate in cities, but a recent report suggests that expanding Medicaid would change that.

According to the report, Utah's urban-rural uninsured gap is among the widest in the country; 31 percent of rural Utahns lack health insurance, compared with 20 percent of city dwellers.

Jessie Mandle, a senior health policy analyst for Voices for Utah Children, said she agrees with the report's conclusion, adding that a major reason is that Utah hasn't expanded Medicaid, while many other states have made the program available to a broader group of low-income adults.

"What we're seeing is a lot of Utahns having to decide if they can afford health care or put food on the table," she said, "and those are decisions that no Utahn should have to make."

The report, from Georgetown University and the University of North Carolina, showed that states that have expanded access to Medicaid have seen drops in uninsured rates three times higher than states that opted not to do so.

Utahns will vote Nov. 6 on a ballot measure to expand Medicaid access through federal funding and a small sales-tax increase. Opponents of the proposition have warned of high costs, but report co-author Joan Alker, executive director of the Georgetown University Center for Children and Families, said expanding Medicaid comes with a number of economic benefits - from shoring up rural hospitals and clinics to healthier communities.

"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," she said, "so they don't get sicker and wind up in the emergency room."

Alker discussed her findings at a Voices for Utah Children event Tuesday and is the keynote speaker at the Children's Champion Awards today in Salt Lake City. Information about that event is online at

The report is online at

Katherine Davis-Young, Public News Service - UT