Recent Changes in Health Insurance Coverage in Rural and Urban Areas
Overview of “Recent Changes in Health Insurance Coverage in Rural and Urban Areas”
There has been concern about the impact of the recent economic downturn on health insurance coverage in the U.S. From 2007 to 2009, an additional 5.6 million adults became uninsured as a result of decreases in the number of adults covered by employer sponsored insurance.i Children also experienced a decline in private coverage during this period; however, due to gains in public coverage, the number of uninsured children actually declined by 600,000 during this period.i Medicaid enrollment increased in all states between July 2008 and December 2009, with the rate of growth peaking during the 6-month period from December 2008 to June 2009.ii iii Historically, Medicaid and the Children’s Health Insurance Program (CHIP) have been an especially important source of coverage in rural areas. Compared to their urban counterparts, rural residents are more likely to be enrolled in public health insurance programs and less likely to be covered by employer-sponsored insurance.iv However, there is little information about whether economic downturns affect health insurance coverage differently in rural and urban areas. This analysis compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession.
Key Findings:
- Between 2007 and 2009 the share of the non-elderly population with public coverage increased while the share with private coverage decreased in both rural and urban areas. This resulted in an increase in the overall uninsurance rate in both rural and urban areas.
- The net changes in coverage over the two year period were not statistically different in rural and urban areas in the U.S. as a whole or within any of the four Census regions.
- Rural residents continued to be less likely to have private coverage and more likely to have public coverage than their urban counterparts. Public health insurance programs continued to play an especially important role for children, who avoided any increase in uninsurance, a trend that was consistent in rural and urban areas.