Medicaid Expansion Strengthens Rural Communities

With the Nebraska Unicameral beginning their 2013 session January 9, it is crucial to recognize that expanding Medicaid as allowed in the Affordable Care Act could reduce - by half - the discouragingly high rural uninsured rates that research at the Center for Rural Affairs reveals.

Many rural Nebraskans face stern challenges in accessing adequate health care coverage. In Nebraska, as in most Midwest and Great Plains states, rural counties have lower health insurance rates than urban counties. Generally, as county population decreases, uninsured rates rise. The only Nebraska counties with uninsured rates at 21 percent or higher are rural.

These differences between urban and rural counties stem from the unique structural barriers and economic challenges that exist in rural Nebraska. And the consequent higher rates of uninsured individuals weaken our rural communities and lead to a less healthy rural Nebraska.

However, Nebraska can reduce the number of rural residents that lack health insurance by working to ensure that the new health insurance marketplaces, or exchanges, meet the unique needs of rural Nebraskans. And for those working adults whose income falls below 138 percent of the federal poverty level - $26,344 for a family of three - our state can make them eligible for the new Medicaid initiative, which would provide them access to healthcare at no cost to the state for three years.

It’s time to make the best choice for all Nebraskans, urban and rural, by moving the expansion of Medicaid to working adults forward.