Medicaid Coverage More Important in Rural Wisconsin than Metropolitan Areas

More people living in small towns and rural WI rely on Medicaid than in cities

June 09, 2017

Children living in rural areas of Wisconsin are more dependent on the Medicaid program than those living in larger metropolitan areas, according to a new study, "Medicaid in Small Towns and Rural America: A Lifeline for Children, Families and Communities," released by Georgetown University Health Policy Institute. Statewide, 34 percent of children with Medicaid coverage live in a rural areas, compared to 31 percent in metropolitan areas of the state.

Slightly more adults are covered by Medicaid (14 percent compared to 13 percent) in non-metropolitan areas than in metro areas of the state, as well.

In seven Wisconsin counties, nearly half of the children are in the Medicaid program. Only one of those--Milwaukee County—is classified as a metropolitan area. See chart below.

"Medicaid is vitally important and in fact disproportionately important for families living in rural America," Joan Alker, executive director of Georgetown’s Center for Children and Families, told reporters on a press call, as reported in Wisconsin Health News (WHN) June 7, 2017.

The report shows the national uninsured rate for children and adults in rural areas has fallen in recent years due to the combination of Medicaid coverage and access to subsidies in the exchange. Wisconsin did not take the federal Medicaid expansion dollars (which to date would have totaled $1.75 billion in federal dollars and expenditures of $680 million less in GPR), but did expand Medicaid to cover all with income below 100 percent of the federal poverty level, adding some 130,000 people who are "in poverty" to Medicaid.

WHA President/CEO Eric Borgerding said the report is a timely reminder of the critical importance of the Medicaid program to the health of children living in rural areas of the state.

"More than 400,000 Wisconsin children are in the Medicaid program. That coverage means they are more likely to receive preventive care and live healthier, more productive lives into adulthood," Borgerding said.

According to the report, people who live in rural areas are more likely to live in poverty, have poorer health and less ability to access health care due to transportation issues.

"A quarter of Wisconsin’s non-elderly population reside in our small towns and rural areas. We must address the very real issues they face, many of which are tied to their ability to access health care," said Borgerding. "When people have coverage, they are more likely to see a physician and receive care. Any changes to the Medicaid program that reduce or remove that access will have a disproportionate impact on the health of our young people and clearly not move us in the direction of becoming a healthier state in the future."

The report noted that the importance of Medicaid for families in small towns and rural areas has grown over time. However, the number of kids who are uninsured is high in some parts of the state. The percent of children who are uninsured in Wisconsin is highest in Clark County, where 35 percent of the kids lack coverage; Milwaukee has the second highest uninsured rate among children at 27 percent.

This story originally appeared in the June 09, 2017 edition of WHA Newsletter