Assuring Health Coverage for Rural Residents Through Health Reform

Rural residents of the United States have a higher uninsured rate than their urban counterparts, and therefore have the most to gain from efforts to reform the U.S. health care system. The differences in health insurance status between those living in rural and urban areas are important to consider in the debate over national reform.

Released by the Rural Policy Research Institute and funded by the Robert Wood Johnson Foundation, the Assuring Health Coverage for Rural People through Health Reform brief suggests that the challenges that rural people face in obtaining health insurance are partly due to the structure of the rural economy: 64 percent of adults working in rural are employed in jobs where health insurance is provided, compared to 71 percent of their urban counterparts. At the same time, rural workers are far more likely to be self-employed. Rural businesses also pay higher premium costs than urban businesses for similar health insurance plans.

Researchers found that health reform proposals that include (i) a subsidy for individual purchase, (ii) availability of insurance plans to individuals and small groups through exchanges, and (iii) expansion of Medicaid would significantly improve coverage for rural populations. In fact, the total number of uninsured people in rural areas would decrease to 1.9 million from the current 8.1 million – leaving only 4.2 percent of rural Americans without insurance, less than the 5.9 percent projected in urban areas.