Authors: Michelle Mills, Chief Executive Officer, Colorado Rural Health Center; Kevin J. Bennett, Professor, University of South Carolina School of Medicine-Columbia
A defining theme in early 2025 has been reducing federal government expenditures, with the health care sector not being spared from the discussions. The withdrawal or reduction of federal support for Medicaid will have potentially devastating impacts on access to essential healthcare services, particularly for vulnerable rural populations such as the elderly, low-income families, and those with chronic conditions. Thus, the National Rural Health Association (NRHA), along with multiple partners both at the federal and state levels have been advocating for maintaining the federal support for Medicaid.
In rural communities, more people receive and rely on Medicaid coverage than their urban counterparts, due to lower incomes, greater percentage of older adults, higher cost of private insurance, and fewer private coverage options. Nearly 40% of children living in rural communities are covered by Medicaid and CHIP, while almost 20% of non- elderly adults are covered.i Cuts to these populations covered under Medicaid and CHIP would be devastating for rural families. Costs of care for our most vulnerable rural residents would rise to unsustainable levels.
If Medicaid funding is reduced, then it will result in higher rates of uninsurance across the US, with a higher impact in our most vulnerable rural areas. These are parents, children, and working adults who would no longer be able to obtain needed health care due to it being unaffordable. These are our neighbors, many of whom have chronic diseases that have to be regularly managed. Without coverage, many would go without care and end up in the emergency room or inpatient facility, resulting in uncompensated care that they will not be able to pay.
Ultimately, reductions in Medicaid funding will force rural facilities to shut their doors and rural residents to lose access to necessary care. NRHA calls on Congress to act as a unified, bipartisan voice to protect Medicaid funding that is vital to the health and economic sustainability of rural communities across the nation.