NASHVILLE, Tenn. – The number of Americans who now have health coverage under the Patient Protection and Affordable Care Act continues to grow, but a new analysis finds that especially in rural states, there are many who still cannot access affordable insurance.
All states were given the option to expand federally backed Medicaid programs, but many did not, including Tennessee.
And Jon Bailey, the director of rural public policy program for the Center for Rural Affairs, said those were mostly states with large rural populations.
“Then the converse is true for states that have a higher portion of their population in urban areas,” Bailey said. “They are more likely to have expanded Medicaid. So, if you live in a rural area, in a state that has a high rural population, it is less likely that you will get the benefits of the Medicaid expansion.”
Tennessee is among the states that have rejected federal dollars to expand their Medicaid programs. However, the debate over whether the state should expand its program is about to resume because the General Assembly is back in session.
In rural states with no Medicaid expansion, there is a significant coverage gap for low-income workers who earn too much to qualify for the health insurance program but not enough to receive tax credits. As a result, many cannot afford to buy policies in the new health insurance marketplaces.
Nationally, Bailey estimates, nearly 1.8 million rural and small-city residents fall into the coverage gap.
Bailey said the number of people falling into that coverage gap, percentage-wise, is about as large as the group of people whose policies did not comply with the new health care program, dubbed “Obamacare.” For that group, some action was taken.
“Congress introduced bills,” Bailey said, adding President Barack Obama did propose a plan “to solve the problem for year.”
“That group of people is almost equal to the people in this coverage gap who have no insurance options at all,” he added, “and really, very few people are talking about how to reduce those people’s problems.”