The Affordable Care Act (ACA) expanded health insurance coverage to previously uninsured populations by allowing states to expand Medicaid coverage to adults with incomes up to 138% of the federal poverty level (FPL) as well as by creating health insurance marketplaces to subsidize affordable coverage. However, states with a higher number or proportion of rural residents were less likely to expand Medicaid than were more urban states. In addition, rural residents eligible for insurance coverage through the new health insurance market place were less likely to enroll in coverage compared to eligible urban residents.
In order to inform timely policy development, the North Carolina Rural Health Research Program surveyed rural providers’ early experiences of the ACA in four states: two that chose to expand Medicaid (Arizona and North Dakota), and two that chose not to expand Medicaid (Georgia and Maine). Our findings brief, Rural Provider Perceptions of the ACA: Case Studies in Four States summarizes perceptions from these states regarding the early effects of the ACA, including changes to patient populations, financial health, and capacity for rural hospitals and rural FQHCs.
Contact Information:
Pam Silberman, JD, DrPH
North Carolina Rural Health Research and Policy Analysis Center
Phone: 919-966-4525
pam_silberman@unc.edu
Additional Resources of Interest:
More information about the North Carolina Rural Health Research and Policy Analysis Center
More information from the Rural Assistance Center, Critical Access Hospitals, Federally Qualified Health Centers, Health Insurance Outreach and Enrollment , Medicaid, Rural Health Clinics, Rural Health Policy topic guide
