a new report Researchers at the U.S. Department of Health and Human Services (HHS) Office of the Assistant Secretary for Planning and Evaluation (ASPE) are examining trends in health care access and outcomes in rural America.
Insurance rates in these areas are improving, but challenges still exist. This report explores these disparities, including differences in urban and rural coverage patterns, barriers to care, and health outcomes, as well as the important role of Medicare, Medicaid, and the Affordable Care Act (ACA). It also describes opportunities to further reduce the
Key findings include:
- The uninsured rate among rural adults under age 65 has declined significantly since the passage of the ACA, falling from 24% in 2010 to 13% in 2023.
- This is primarily due to the ACA’s Medicaid expansion, which allowed states to extend eligibility to adults with incomes up to 138% of the federal poverty level (FPL). As a result, Medicaid enrollment rose from 12% of the rural population in 2010 to 17% in 2020. It will reach 21% in 2023, matching the conditions for continued participation under the public health emergency caused by the novel coronavirus infection. Additionally, the uninsured rate among rural residents is consistently higher in states that have not yet adopted the ACA’s Medicaid expansion (16%) than in states that have (12%).
- Recent legislation (the American Rescue Plan Act of 2021 and the Inflation Reduction Act of 2022) has enhanced the Premium Tax Credit (PTC) for insurance purchases on the ACA Marketplaces. Eligible rural consumers received an increase of $74 per month in PTC, while urban consumers received an increase of $58 per month. Overall, these enhanced PTCs save rural enrollees an average of $890 per year, about 28% more than urban enrollees.
- Despite these successes, rural Americans still have higher uninsured rates than their urban counterparts, and achievement disparities persist. ASPE notes that while rural communities are diverse, some commonalities may be contributing factors, including long distances to care, limited infrastructure, and a lack of health care providers. Masu.
- Importantly, programs and services such as telemedicine, health workforce programs, health centers, Indian Health Services, tribally operated health facilities, and rural clinics not only help by improving access to health care; It can strengthen federal and state health programs such as: Medicare, Medicaid, ACA.
Medicare Rights agrees with ASPE that “an important way to increase access to care is to expand health insurance coverage.” The ACA and its Medicaid expansion achieved significant success in reducing rural uninsured rates. Simplifying Medicare enrollment and increasing access to programs such as the Medicare Savings Program that make coverage more affordable, as well as increasing eligibility and enrollment assistance for rural populations, will increase enrollment rates and access to care. Access could be even better. We also support related strategies to improve health outcomes and minimize rural-urban disparities, including telemedicine, infrastructure improvements, health workforce programs, and caregiver support.
