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

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  • Bidisha Mandal

Abstract

The 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.

Suggested Citation

  • Bidisha Mandal, 2022. "Rural–Urban Differences in Health Care Access and Utilization under the Medicaid Expansion," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 44(2), pages 702-721, June.
  • Handle: RePEc:wly:apecpp:v:44:y:2022:i:2:p:702-721
    DOI: 10.1002/aepp.13111
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    References listed on IDEAS

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    1. Frean, Molly & Gruber, Jonathan & Sommers, Benjamin D., 2017. "Premium subsidies, the mandate, and Medicaid expansion: Coverage effects of the Affordable Care Act," Journal of Health Economics, Elsevier, vol. 53(C), pages 72-86.
    2. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2018. "Early Effects of the Affordable Care Act on Health Care Access, Risky Health Behaviors, and Self‐Assessed Health," Southern Economic Journal, John Wiley & Sons, vol. 84(3), pages 660-691, January.
    3. Christopher Brunt & Gail Jensen, 2014. "Payment generosity and physician acceptance of Medicare and Medicaid patients," International Journal of Health Economics and Management, Springer, vol. 14(4), pages 289-310, December.
    4. Laurence C. Baker & Anne Beeson Royalty, 2000. "Medicaid Policy, Physician Behavior, and Health Care for the Low-Income Population," Journal of Human Resources, University of Wisconsin Press, vol. 35(3), pages 480-502.
    5. Getzen, Thomas E., 2000. "Health care is an individual necessity and a national luxury: applying multilevel decision models to the analysis of health care expenditures," Journal of Health Economics, Elsevier, vol. 19(2), pages 259-270, March.
    6. Kosali Simon & Aparna Soni & John Cawley, 2017. "The Impact of Health Insurance on Preventive Care and Health Behaviors: Evidence from the First Two Years of the ACA Medicaid Expansions," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(2), pages 390-417, March.
    7. Donald Freeman, 2003. "Is health care a necessity or a luxury? Pooled estimates of income elasticity from US state-level data," Applied Economics, Taylor & Francis Journals, vol. 35(5), pages 495-502.
    8. Nicholas Moellman, 2020. "Healthcare and Hunger: Effects of the ACA Medicaid Expansions on Food Insecurity in America," Applied Economic Perspectives and Policy, John Wiley & Sons, vol. 42(2), pages 168-186, June.
    9. Charles Courtemanche & James Marton & Benjamin Ukert & Aaron Yelowitz & Daniela Zapata, 2017. "Early Impacts of the Affordable Care Act on Health Insurance Coverage in Medicaid Expansion and Non‐Expansion States," Journal of Policy Analysis and Management, John Wiley & Sons, Ltd., vol. 36(1), pages 178-210, January.
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