Rural–Urban Differences in Health Care Access and Utilization under the Medicaid Expansion

Abstract

AbstractThe Affordable Care Act's Medicaid expansion ushered in substantial increases in enrollment in the public insurance program. I analyzed rural–urban differences in access to health insurance, financial access to primary care providers, use of preventive care, and use of emergency department for medical reasons that did not lead to hospitalization. Low‐income rural residents were found to have greater reduction in likelihood of uninsurance than their urban counterparts. While an increase in the likelihood of routine check‐ups was found to be significant only among rural residents, a decrease in the likelihood of repeated visits to the emergency departments for nonurgent reasons was only significant among the urban population. I highlight the importance of understanding rural experiences to reduce rural–urban health disparities.