Sources of insurance coverage in nonmetropolitan areas: the role of public and private insurance since 2009
- Collection:
- Health Policy and Services Research
- Series Title(s):
- Rural policy brief
- Author(s):
- Li, Linda, author Najarian, Matthew, author Barker, Abigail R., author McBride, Timothy D., author Mueller, Keith J., author
- Contributor(s):
- RUPRI Center for Rural Health Policy Analysis, issuing body. Rural Health Research & Policy Centers, issuing body. Rural Policy Research Institute (U.S.), issuing body.
- Publication:
- Iowa City, IA : Rural Policy Research Institute, March 2021
- Language(s):
- English
- Format:
- Text
- Subject(s):
- Insurance Coverage -- statistics & numerical data Insurance Coverage -- trends Insurance, Health -- statistics & numerical data Insurance, Health -- trends Private Sector Public Sector Rural Health Services -- statistics & numerical data Rural Health Services -- trends Rural Population Urban Population United States
- Genre(s):
- Technical Report
- Abstract:
- Over the past decade, health insurance coverage trends show an increased reliance on public sources of coverage. However, little is known regarding the relative importance of the different sources of coverage in nonmetropolitan areas compared to metropolitan areas. This brief uses the American Community Survey (ACS) 5-year estimates from 2009 to 2013 and 2013 to 2017 to compare types of health insurance coverage for the nonelderly (all ages < 65) in metropolitan and nonmetropolitan areas (as defined by the Office of Management and Budget). Using these data, the regional variation in insurance coverage rates is described, examining sources of coverage before and after the implementation of the Patient Protection and Affordable Care Act (PPACA). Key Findings. (1) From 2009 to 2017, nonelderly individuals in nonmetropolitan areas had significantly higher rates of public insurance coverage and lower rates of employer-sponsored insurance coverage compared to individuals in metropolitan areas. (2) Post-PPACA implementation, nonelderly individuals living in Medicaid expansion states experienced significant growth in public insurance rates compared to those living in nonexpansion states. This increase was larger for those living in nonmetropolitan areas compared to metropolitan areas. (3) There was little increase in the rate of employer-sponsored insurance in either metropolitan or nonmetropolitan areas from 2009 to 2017. Most of the growth in private insurance coverage was composed of direct purchases from the marketplace. The rate of direct purchase of health insurance was higher in nonexpansion states than in expansion states. (4) Pre and post-PPACA, uninsured rates were higher in nonmetropolitan areas than in metropolitan areas and remained the highest in nonexpansion states. The overall differential in uninsured rates between metropolitan and nonmetropolitan areas grew between 2009 and 2017 and was driven by expansion status.
- Copyright:
- The National Library of Medicine believes this item to be in the public domain. (More information)
- Extent:
- 1 online resource (1 PDF file (5 pages))
- Illustrations:
- Illustrations
- NLM Unique ID:
- 9918350984406676 (See catalog record)
- Permanent Link:
- http://resource.nlm.nih.gov/9918350984406676