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Rural Coverage Gaps Decline Following Public Health Insurance Expansions (Policy Brief)
Key findings and policy implications:

• Between 1997 and 2005, the uninsured rate among rural children declined more dramatically than among urban children, following increases in public health insurance, whereas public health insurance growth among rural adults was much more modest and uninsured rates remained the same.
• Nearly 60% of the rural uninsured have family incomes below 200% of the federal poverty level suggesting the potential for expanding public coverage.
• For those with higher incomes, policy strategies to strengthen private coverage will need to account for the unique employment and insurance market characteristics of rural areas.
• Rural residents have a greater risk of being "underinsured", therefore reform efforts should help ensure that available plans have benefit designs that meet their healthcare needs at an out-of-pocket cost commensurate with income.

Contact information:
Erika Ziller, MS
Maine Rural Health Research Center
Phone: 207-780-4615
eziller@usm.maine.edu

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Rural Adults Face Parity Problems and Other Barriers to Appropriate Mental Health Care (Policy Brief)
Findings suggest that a multi-level approach is essential for meeting the mental health service needs of rural residents. Key findings:

• Eight percent of rural adults say that they are in "fair" or "poor" mental health versus six percent of urban adults.
• Among those using mental health services, rural residents are more likely than urban residents to use medication but not therapy. Practice guidelines for quality mental health treatment recommend that medications be given in combination with therapy.
• Both rural and urban adults have greater cost sharing for their mental health care than for their total health care use. The percentages do not differ by residence; however, rural residents may be at greater risk of forgoing mental health care due to costs.

Contact information:
Erika Ziller, MS
Maine Rural Health Research Center
Phone: 207-780-4615
eziller@usm.maine.edu

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Rural Children Don't Receive the Mental Health Care They Need (Policy Brief)
Examines rural and urban differences in the use of children's mental health services and the role that family income, health insurance, and mental health status play in explaining those differences. Key findings and policy implications:

• The prevalence of mental health problems is very similar in rural and urban areas; however rural children are less likely than urban children to have a mental health visit.
• Rural children are more likely to be poor or near-poor and have Medicaid or SCHIP.
• Public health insurance programs such as Medicaid and SCHIP are important policy tools for enhancing and ensuring the access of rural children to mental health care.
  

Contact information:
David Lambert, PhD
Maine Rural Health Research Center
Phone: 207-780-4502
davidl@usm.maine.edu

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