Health Insurance Dynamics of Uninsured Rural Families

Research center:
Lead researcher:
Project completed:
August 2005
Numerous studies have found higher uninsured rates among rural versus urban residents, yet our understanding of the health insurance coverage of rural families remains limited. This is because the previous studies have focused on the insurance status of rural individuals despite growing recognition among researchers and policymakers that health insurance is what the Institute of Medicine (IOM) calls "A Family Matter" (IOM 2002). To better understand the dynamics of insurance coverage among rural and urban families, this study will use the Medical Expenditure Panel Survey (MEPS) to compare family health insurance coverage among non-elderly rural and urban families.

This study has three objectives:

  • In households with at least one uninsured member, to determine if there are rural-urban differences in family-level insurance status (fully insured, partially insured, or completely uninsured.
  • Among families with mixed coverage, to identify the insurance status of other family members (Medicare, Medicaid, employer-sponsored, and non-group private).
  • To determine what employment and socioeconomic characteristics are associated with rural families' health insurance mix and whether these characteristics are the same or different than for urban families.

Given that current strategies to address the uninsured appear to be focused almost exclusively on incremental health insurance reform, the findings from this study will assist policy-makers in determining how to build on existing insurance systems in ways that will be most effective for rural families.

Findings from this study will include a working paper, a research and policy brief, presentations at national conferences, and submission to a peer-reviewed journal.