This research examined rural-urban (i.e., non-metropolitan/metropolitan) differences in affordability inclusive of insurance coverage and cost barriers. The research also examined forgoing medical care/medication and medical debt using Behavioral Risk Factor Surveillance System survey data from the healthcare access optional module.

Key Findings:

• Non-Hispanic White and non-Hispanic Black adults ages 18-64 living in non-metropolitan areas had lower health insurance rates than their metropolitan counterparts.
• Among non-metropolitan individuals, insurance coverage varied across racial/ethnic groups. Hispanic adults had the lowest health insurance rates.
• Non-Hispanic Black individuals reported higher levels of forgoing medical care due to cost (18.3% metropolitan and 22.5% non-metropolitan) compared to their White counterparts (13.3% metropolitan and 13.7% non-metropolitan).
• Non-metropolitan individuals ages 18-64 were more likely to report forgoing medication due to cost (11.3%) than metropolitan individuals (9.4%).
• A larger proportion of non-metropolitan individuals (24.0%) reported having medical bills they were paying off over time than those living in metropolitan (20.8%) areas.