Study: Medicaid cuts would hurt rural people most

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Recent gains in the number of people insured will be in jeopardy under health-care bills in Congress, largely from a proposed dramatic cut in federal funding for Medicaid, reports Phil Galewitz of Kaiser Health News.

"There is no doubt that children and families in small towns would be disproportionately harmed by cuts to Medicaid," Joan Alker, executive director of the Georgetown University Center for Children and Families, told Galewitz.

"According to the center's new report, Medicaid covered 45 percent of children and 16 percent of adults in small towns and rural areas in 2015," Galewitz explains. "Those figures are lower in metropolitan areas – 38 percent of children and 15 percent of adults. Rural areas have larger Medicaid populations because more people with disabilities live there, household incomes tend to be lower, unemployment rates higher and jobs with employer-paid insurance less common, the Georgetown report said. In states that expanded Medicaid under Obamacare, the rate of uninsured people in small towns and rural areas fell by 11 percentage points between 2008-09 and 2014-15 – from 22 percent to 11 percent, the report said. That was slightly larger than the decrease in metro areas of expansion states."

Other findings from the report: Rural areas tend to have larger Medicaid populations because more people with disabilities live there, household incomes tend to be lower, unemployment rates higher and jobs with employer-paid insurance less common. In states that expanded Medicaid under the ACA the rate of uninsured people in small towns and rural areas fell by 11 percentage points between 2008-09 and 2014-15, from 22 percent to 11 percent, a slightly larger decrease than in metro areas of expansion states.

The House bill would stop funding of the Medicaid expansion in 2020. Senate Republicans have not released a bill, but Senate Majority Leader Mitch McConnell has proposed a phase-out through 2023, The Hill reports.