Medicaid and the Children's Health Insurance Program (CHIP) are important sources of health insurance coverage, especially in rural communities. In 2007, we created a website with state-level Medicaid enrollment data in rural and urban areas and other rural-relevant program data. Preliminary results from our current study using these data indicate that Medicaid/CHIP participation rates are slightly higher in rural areas nationally, but that rural-urban participation rates vary by state. It is likely that the importance of Medicaid/CHIP will grow as job-based health insurance coverage continues to erode and policymakers pursue the goal of expanding coverage.

This project has three mini-studies that: 1) Update and maintain our State Profiles of Medicaid and CHIP in Rural and Urban Areas website, adding information on Medicaid Disproportionate Share Hospital (DSH) payments to rural hospitals; 2) Analyze trends in Medicaid/CHIP enrollment in rural and urban areas over the past two to three years; and 3) Explore the future role of CHIP given increasing levels of childhood poverty. Publications will include the updated website, a Final Report, and a journal article about barriers to participation.

Publications

• Recent Changes in Health Insurance Coverage in Rural and Urban Areas
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 05/2011
  This findings brief compares changes in health insurance coverage for non-elderly Americans in rural areas to changes in urban areas during the recent economic recession.
• States' Use of Cost-Based Reimbursement for Medicaid Services at Critical Access Hospitals
  North Carolina Rural Health Research and Policy Analysis Center
  Date: 04/2010
  This brief documents which states utilize a cost-based reimbursement methodology for Medicaid.