RTC:Rural fact sheet explores insurance coverage rates before and after ACA and Medicaid expansion

September 17, 2019


The passage of the Patient Protection and Affordable Care Act (ACA) and adoption of Medicaid expansion was associated with substantial increases in insurance coverage across the United States (see Changes in coverage and access, MACPAC 2019). However, RTC:Rural researchers wanted to know how ACA policy changes and Medicaid expansion impacted people with disabilities, particularly those who live in rural areas.

To explore this question, RTC:Rural researchers analyzed microdata from the 2008-2013 American Community Survey from IPUMS-USA. Using these data, they were able to compare how insurance coverage has changed over time for people with and without disabilities in rural and urban places, and in expansion and non-expansion states.

They found that rural people with disabilities had the greatest gains in insurance coverage following implementation of the ACA. Rural people with disabilities in Medicaid expansion states saw a 10.7% increase in insurance coverage, compared to a 5.3% increase for those in non-expansion states. The loss of the ACA and Medicaid expansion could hurt rural people with disabilities more than their urban counterparts, or those without disabilities.

To learn more about these results and analyses, follow the link below to download the fact sheet from the RTC:Rural and Rural Institute ScholarWorks collection:

ACA and Medicaid Expansion Associated with Increased Insurance Coverage for Rural Americans with Disabilities

The fact sheet is available to download as an accessible PDF and in text-only format (Word document).