While the Affordable Care Act led to pronounced gains in insurance coverage in rural areas, particularly among low-income individuals, rural residents continue to have higher rates of uninsurance than their urban counterparts. Research also suggests that paying for healthcare remains a substantial rural concern. A recent survey of rural adults identified financial challenges, followed by health and healthcare issues, as the most pressing problems facing rural families, with many citing affordability as the reason for delaying or foregoing needed care.

Although it's known that healthcare affordability remains a concern for many rural residents, it is unclear to what extent factors such as insurance coverage gains or the growing trend of high deductible health plans have influenced rural experiences of cost-related barriers to care and whether rural populations continue to experience more such barriers than do urban residents. This project addressed this research gap by comparing rural and urban differences in healthcare access and affordability.

Publications

• Rural Working-Age Adults Report More Cost Barriers to Health Care
  Policy Brief
  Maine Rural Health Research Center
  Date: 03/2023
  Using the 2019-2020 National Health Insurance Survey, this study examined rural-urban differences in affordability of care and cost-saving strategies among working-age adults.