|The study has an interactive map that gives county-by-county data. A screenshot highlights Bell County,|
which had the highest share of adults on Medicaid in Kentucky in 2014-15, according to the study.
Kentucky Health News
Adults in Kentucky's rural areas and small towns are more dependent on Medicaid for their health coverage than their counterparts in almost any other state. That is among the findings of a study by the Georgetown University Center for Children and Families and the health-services research center at the University of North Carolina.
The findings are especially relevant at a time when Congress is debating the future of the Medicaid expansion under the Patient Protection and Affordable Care Act. The bill passed by the House would end the expansion in 2020; Senate Majority Leader Mitch McConnell has proposed a phase-out through 2023. President Trump said in his campaign that he would not cut Medicaid, but he supported the House bill.
California's rural population at the 2010 census was slightly larger than Kentucky's, but its number was a much smaller percentage of its rural and small-town population, only 5 percent; Arizona's was 10 percent; New Mexico's was 23 percent; Kentucky's was 42 percent. From 2008-09 to 2014-15, California and Kentucky had the second largest percentage-point increase in adults in Medicaid, 14 points; Oregon rose 17 points.
The Medicaid expansion gave Oregon and Kentucky the greatest reductions in the percentage of adults without health coverage; Oregon dropped 19 points, from 31 percent to 12 percent; and Kentucky dropped 17 points, from 26 percent to 10 percent in 2015.
The study focused on Medicaid's impact on children in rural areas and small towns, defined as those with less than 50,000 people. It found that in 2014-15, Medicaid covered 45 percent of children and 16 percent of adults in those areas, compared to 38 percent and 15 percent, respectively, in metropolitan areas. In Kentucky, Medicaid covered 49 percent of children outside metro areas and 36 percent in those areas.
The numbers include children in the Children's Health Insurance Program. Kentucky adopted the program many years ago, so it saw only a 1 percent increase in rural and small-town children on Medicaid and a 2 percentage-point drop in uninsured children in those areas.