This brief uses the Medical Expenditure Panel Survey
(MEPS) to compare the health insurance coverage of rural
and urban residents in 1997 and 2005 to assess how
uninsured rates and sources of coverage have changed
since SCHIP was enacted. The authors also discuss the
characteristics of the rural uninsured and the
implications for health insurance reform. Rural is
defined as living in a non-metropolitan county, as
designated by the Office of Management and Budget (OMB).
All presented results are statistically significant at p.
Findings: Between 1997 and 2005, the uninsured rate among
rural children declined more dramatically than among
urban children, following increases in public health
insurance. 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