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This Is How Medicaid Requirements Might Affect Rural Americans

Medicaid functions as an economic lifeline to several communities across the United States. It delivers healthcare to those living in the rural parts of the country. Approximately 25% of the non-elderly adults residing in rural areas have their health costs covered through Medicaid. Medicaid has undergone an expansion under the ACA or Affordable Care Act, thereby benefiting the adults belonging to the low-income stratum. Some states in the U.S. have adopted the Medicaid expansion, while some haven’t. The rural areas in the non-expansion states haven’t experienced coverage gains as high as those which have adopted the expansion. Uncompensated care expenses are on the decline in rural hospitals, and the number of such hospitals closing down is few.

Medicaid and Trump Administration

Healthcare coverage through Medicaid has taken a hit owing to a decision taken by the Trump administration. The states have been given the authority to take away from or deny Medicaid coverage to those who have no documents to show that they are either working or taking part in activities related to work for the stipulated number of hours every month. This decision will prove detrimental for rural America. It’s a fact that multiple rural communities avail themselves of healthcare coverage through Medicaid. However, the number of unemployed people in the rural parts is quite high. Aside from that, there are infrastructural as well as transportation challenges that they have to cope with. Therefore, adhering to the requirements becomes an uphill task for them.

All these factors combined will eventually lead to a significant number of people in rural America losing their health coverage. This is disastrous as people’s access to healthcare will worsen with time. Aside from that, the economic challenges will also aggravate the rural hospitals and providers. In Arkansas, more than 18,000 people who received coverage through Medicaid, lost it in the year 2018, after the policy’s new requirements were laid down. While Arkansas’ policy has been put on hold by a federal court, the administration seems to be in no mood to stop approving similar policies elsewhere.

Medicaid is Essential for the Rural Communities

Around 20% of Americans reside in rural areas. Those parts of the country are known for their distinct health and economic conditions. The rate of unemployment is quite high and incomes are comparatively on the lower side, as compared to the metropolitan areas. The employers in the rural areas wouldn’t probably offer a health insurance policy. Farming is a prevalent occupation which means that people are mostly self-employed.

In that case, the only health coverage they can get is Medicaid. Therefore, it doesn’t come as a surprise that Medicaid has such a vital role to play in covering the health costs of rural Americans. In 2015, 24% of non-elderly adults living in the rural regions received coverage from Medicaid, while 22% of the non-elderly adults living in the urban areas got covered. After the expansion, the percentage in rural areas of the states that complied with the Medicaid expansion dropped drastically.

Rural People Might Lose Medicaid Coverage

If the opinion of the independent experts is taken into account, several Medicaid enrollees are on their way to lose health coverage owing to the Trump Administration’s policy of work requirement. Most of the rural people are likely to stay uninsured. According to the researchers of the Kaiser Family Foundation, if the policy’s work requirements are brought into action across the United States, the number of people who would lose health coverage can be estimated to be in the range of 1.4 million to 4 million. Paperwork requirements are the biggest hurdle. Additionally, unemployment and not being able to reach the threshold are two other big factors.

The Exemption of Unemployed People Wouldn’t Mean Much

Some state administrations have come up with proposals to exempt those who are living in areas having higher unemployment, especially the rural regions. With that being said, such a step wouldn’t mean much. Some of the carveouts are not exempting the unemployed residents from the work requirement. Some states are just interested in expanding the list of activities that are related to work to fit in more people. Others are leaving only an insignificant number of rural people.

Work requirements are actually leading to coverage losses. Rural hospitals are having a tough time operating and serving the rural communities in states that haven’t adopted the Medicaid expansion. It’s a tough time for them.

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