Study Finds Rural Regions/Small Towns Hardest Hit by Proposed Medicaid Cuts

Jun 8, 2017

A new national study finds Medicaid and the Children’s Health Insurance Program (CHIP) play a larger role in providing health coverage for children and adults living in small towns and rural areas than it does for those living in metropolitan regions.  The report’s analysis finds that to be true in Florida as well. Researchers with the Center for Children and Families at Georgetown University’s Health Policy Institute and the University of North Carolina’s Rural Health Research Program in Chapel Hill released the analysis June 7.

The nonpartisan analysis finds that nationally, Medicaid provides health insurance for 45 percent of children living in small towns and rural areas compared to 38 percent of kids living in metro areas.  Florida was among 14 states identified in the report where Medicaid provided coverage for more than half of children living in the state’s small town and rural areas.  Florida ranked fourth in that listing with 57 percent behind Arkansas, Mississippi and New Mexico. 

Credit Medicaid in Small Towns in Rural America Report

Using insurance coverage data from the U.S. Census Bureau, researchers also compared rates of children on Medicaid in small towns and rural areas in 2008-2009 before implementation of the Affordable Care to rates of those same children on Medicaid in 2014-2015.  The report finds that nationally, rates of Medicaid coverage for children increased five percent overall.  Florida, however, had the third highest rate increase of kids in rural and small town areas over the same time period at 14 percent.

Credit Medicaid in Small Towns and Rural America Report

Even though the report compares rates of Medicaid coverage from years both before and after implementation of the Affordable Care Act, Georgetown University research professor and Executive Director of the school’s Center for Children and Families, Joan Alker, said Obamacare was not the main factor when it comes to Medicaid coverage gains for kids.

“For children, this is not primarily the result of the Affordable Care Act, but rather a many-decades long bi-partisan effort to ensure that children have coverage which began all the way back in the 1980s with expansions of Medicaid to children under the poverty line continuing with the passage of the Children’s Health insurance program in 1997,” said Alker.

“Florida has typically been a pretty low performer nationwide and in the South, but despite that, Florida has seen success.  This is a national trend and Florida is not immune from this progress.”

Credit Medicaid in Small Towns and Rural America Report

The report also ranks Florida in sixth place when it comes to states that have experienced the greatest overall declines in uninsured children.  “So in these small towns and rural areas, we saw that in Florida, the rate of uninsured kids dropped from 16 percent to 9 percent in the time that we examined,” said Alker.

While Alker emphasizes that the report’s findings are positive overall, she says Florida has several demographic features that account for the state’s relatively high rate of uninsured children.  “Florida has a lot of smaller employers and also employers in the service sector; the tourism industry which typically don’t offer health insurance,” said Alker.  “Florida also has a relatively high percentage of Latino children and families that end to have a higher uninsured rate.”

The report comes at a time when the U.S. Senate is considering a healthcare overhaul already passed by the U.S. House (H.R. 1628) known as the American Health Care Act of 2017.  That measure would cut Medicaid funding by an estimated $839 billion over ten years, according to analysis from the Congressional Budget Office.  Alker expressed concern about the House measure, characterizing the impact of such Medicaid cuts as “devastating.”

“There’s no place for children to run and hide when you see cuts of that magnitude,” said Alker.  “So as the Senate takes up the bill it is very important for Floridians to be mindful of what an important role Medicaid is playing in your state and really for the future of your state given its importance for children.”

Alker said the House proposed cuts to Medicaid have “really nothing to do with the Affordable Care Act.  It’s a radical restructuring of the financing that Medicaid has had in place for over 50 years,” said Alker.

“So, I think there should be a great deal of concern about a change of that magnitude that’s being rushed through with no hearings on either side so far and that Floridians should certainly ask their senators questions about what this means for Florida and what it means for the rest of the country.”