Today, the National Rural Health Association’s 2015 president Jodi Schmidt addressed the U.S. Senate Democratic Steering Committee to commemorate the 50th anniversary of the Medicaid program.
Sen. Amy Klobuchar (D-Minn.) and several of her colleagues listened as top health care experts detailed the importance Medicaid has played in improving health outcomes.
Poverty persists in rural America, and Medicaid continues to be crucially important for rural patients and rural providers. In fact, because rural Americans tend to be older, poorer and sicker than their urban counterparts, Medicaid is a larger source of health care in rural America than in the rest of the nation and has literally been a lifeline for millions who live in rural communities. Poverty in rural America is generational. Poverty rates are higher for rural children than for those living in urban areas, and the gap has increased in recent years. Rural children are more likely than urban children to live in extreme poverty. More than 42 percent of low-income rural children rely on Medicaid and the Children’s Health Insurance Program (CHIP).
As we know, 22 states have chosen to not expand Medicaid per provisions of the Affordable Care Act. It’s important to note that the majority of rural residents in the U.S. live in states that are not expanding Medicaid. Only three of the 11 states with the largest rural populations have expanded (Iowa, Kentucky and Michigan). In fact, rural, poor states are the least likely to expand Medicaid. Many rural hospitals are bearing the brunt, as sick and uninsured patients continue to show up in emergency rooms. Uncompensated care cuts such as DSH and bad debt reductions, on top of sequestration cuts, are forcing rural hospitals to close.
Have we made progress in the last half century? Over 50 years ago in Martin County, Ky., where the poverty rate was 65 percent, President Lyndon Johnson, declared an “unconditional war on poverty.” Today, Martin County remains one of the poorest counties in the nation with a 35 percent poverty rate, nearly double the national average. Progress? Yes, but it is undeniable that poverty continues to be a persistent reality for much of rural America.