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The Role of Medicaid in Rural America

Appendix Table 1: Nonelderly Population by Geographic Area, 2015
  % in Rural Areas % in Urban Areas % in Other Areas
United States 19% 20% 60%
Alabama 34% 0% 66%
Alaska 59% 0% 41%
Arizona 17% 0% 83%
Arkansas 51% 0% 49%
California 3% 10% 86%
Colorado 19% 13% 68%
Connecticut 0% 51% 49%
Delaware 0% 0% 100%
DC 0% 100% 0%
Florida 5% 4% 91%
Georgia 22% 37% 40%
Hawaii 18% 0% 70%
Idaho 52% 0% 48%
Illinois 15% 54% 31%
Indiana 30% 15% 56%
Iowa 52% 0% 48%
Kansas 46% 0% 54%
Kentucky 49% 17% 34%
Louisiana 33% 0% 67%
Maine 45% 0% 55%
Maryland 4% 11% 85%
Massachusetts 1% 46% 53%
Michigan 21% 18% 61%
Minnesota 34% 33% 33%
Mississippi 60% 0% 40%
Missouri 35% 22% 43%
Montana 100% 0% 0%
Nebraska 44% 0% 56%
Nevada 9% 0% 91%
New Hampshire 25% 0% 75%
New Jersey 0% 43% 57%
New Mexico 67% 0% 33%
New York 10% 51% 39%
North Carolina 22% 11% 67%
North Dakota 100% 0% 0%
Ohio 20% 29% 51%
Oklahoma 47% 0% 53%
Oregon 32% 0% 68%
Pennsylvania 12% 33% 55%
Rhode Island 0% 0% 100%
South Carolina 24% 0% 76%
South Dakota 78% 0% 22%
Tennessee 30% 0% 70%
Texas 15% 34% 51%
Utah 24% 0% 76%
Vermont 73% 0% 27%
Virginia 23% 34% 43%
Washington 16% 0% 84%
West Virginia 46% 0% 54%
Wisconsin 33% 17% 49%
Wyoming 100% 0% 0%
NOTES: Includes nonelderly individuals ages 0-64. Totals may not sum to 100% due to rounding. Totals for Hawaii do not sum to 100% because FIPS county codes 15005 and 15009 are not assigned an IRR; population in geographic area is N/A.

SOURCE: Kaiser Family Foundation analysis based on the 2015 American Community Survey 1-Year Estimates.

Appendix Figure 1: Share of Nonelderly Population in Rural Area by State, 2015

Appendix Table 2: Demographics by Geographic Area, 2015
Rural Urban Other
Mean Index of Relative Rurality, 2010 0.51 0.13 0.34
Nonelderly (0-64)
Age 30% 28% 29%
   0-18  30% 28% 29%
   19-34 24% 28% 26%
   35-54 30% 31% 31%
   55-64 17% 14% 15%
Sex
   Male 50% 49% 50%
   Female 50% 51% 50%
Race/Ethnicity
   Non-Hispanic White 76% 45% 58%
   Non-Hispanic Black 8% 21% 11%
   Hispanic 10% 22% 21%
   Non-Hispanic Other Race 5% 12% 9%
Citizenship
   Citizen 96% 79% 86%
   Naturalized Citizen 1% 9% 6%
   Non-Citizen 3% 12% 8%
Poverty
   <100% FPL 18% 16% 15%
   100-199% FPL 20% 17% 17%
   200-399% FPL 32% 26% 29%
   400% FPL 28% 40% 38%
Census Region
   Northeast 8% 35% 14%
   Midwest 31% 26% 16%
   South 42% 31% 38%
   West 19% 7% 31%
Nonelderly Adults (19-64)
Education
   Less than High School 11% 12% 11%
   High School Diploma or GED 34% 23% 25%
   Some College 36% 28% 34%
   Bachelor’s Degree or Higher 19% 37% 30%
Work Status
   Working 70% 74% 73%
   Unemployed 4% 5% 5%
   Not in Labor Force 26% 21% 22%
Disability
   With Disability 14% 9% 10%
   Without Disability 86% 91% 90%
NOTES: People of Hispanic origin may be of any race but are categorized as Hispanic for this analysis; all other racial groups are non-Hispanic. Disability includes limitation in vision, hearing, mobility, cognitive functioning, self-care, and/or independent living.

SOURCE: Kaiser Family Foundation analysis of the 2015 American Community Survey 1-Year Estimates.

Appendix Table 3: Health Coverage Among the Nonelderly Population by Geographic Area, 2015
Medicaid Other Public Private Uninsured
Rural Urban Other Rural Urban Other Rural Urban Other Rural Urban Other
United States 24% 22% 21% 4% 2% 3% 61% 64% 66% 12% 11% 10%
 Implemented Medicaid Expansion- Democratic/Independent Governor
California 37% 21% 28% 3% 1% 3% 49% 69% 60% 11% 9% 10%
Colorado 26% 23% 18% 4% 2% 5% 57% 62% 70% 12% 13% 8%
Connecticut N/A 21% 20% N/A 1% 2% N/A 69% 73% N/A 9% 5%
Delaware N/A N/A 23% N/A N/A 3% N/A N/A 67% N/A N/A 6%
DC N/A 26% N/A N/A 2% N/A N/A 68% N/A N/A 4% N/A
Hawaii 28% N/A 15% 3% N/A 12% 64% N/A 69% 5% N/A 4%
Louisiana 25% N/A 23% 4% N/A 4% 55% N/A 60% 16% N/A 13%
Minnesota 22% 21% 15% 2% 1% 1% 70% 72% 79% 5% 6% 4%
Montana 17% N/A N/A 4% N/A N/A 66% N/A N/A 14% N/A N/A
New York 26% 31% 21% 4% 1% 2% 63% 58% 71% 7% 10% 6%
Oregon 31% N/A 24% 3% N/A 2% 56% N/A 66% 9% N/A 8%
Pennsylvania 22% 22% 18% 3% 2% 2% 67% 69% 73% 8% 8% 7%
Rhode Island N/A N/A 24% N/A N/A 2% N/A N/A 68% N/A N/A 6%
Washington 30% N/A 21% 4% N/A 4% 56% N/A 68% 10% N/A 7%
West Virginia 32% N/A 28% 4% N/A 4% 57% N/A 62% 7% N/A 6%
Alaska 19% N/A 20% 8% N/A 9% 55% N/A 60% 19% N/A 11%
 Implemented Medicaid Expansion- Republican Governor
Arizona 32% N/A 22% 5% N/A 3% 48% N/A 62% 15% N/A 13%
Arkansas 33% N/A 23% 4% N/A 4% 52% N/A 62% 11% N/A 11%
Illinois 25% 22% 20% 2% 2% 2% 67% 67% 71% 6% 10% 6%
Indiana 17% 26% 17% 3% 3% 3% 69% 58% 70% 11% 14% 11%
Iowa 20% N/A 18% 2% N/A 2% 72% N/A 74% 6% N/A 6%
Kentucky 32% 24% 23% 6% 2% 4% 54% 67% 67% 8% 6% 7%
Maryland 25% 34% 16% 3% 3% 4% 66% 53% 73% 6% 9% 7%
Massachusetts 24% 21% 28% 1% 1% 2% 71% 75% 67% 4% 3% 3%
Michigan 25% 37% 21% 3% 2% 2% 64% 53% 71% 8% 8% 6%
Nevada 21% N/A 20% 3% N/A 4% 65% N/A 62% 11% N/A 14%
New Hampshire 17% N/A 12% 3% N/A 3% 69% N/A 78% 11% N/A 7%
New Jersey N/A 19% 18% N/A 1% 2% N/A 68% 72% N/A 13% 8%
New Mexico 36% N/A 32% 4% N/A 5% 47% N/A 52% 13% N/A 11%
North Dakota 11% N/A N/A 4% N/A N/A 76% N/A N/A 9% N/A N/A
Ohio 24% 24% 22% 3% 2% 3% 65% 66% 68% 8% 8% 7%
Vermont 29% N/A 21% 2% N/A 2% 63% N/A 74% 6% N/A 4%
 Has Not Implemented Medicaid Expansion- Democratic Governor
North Carolina 24% 16% 19% 5% 2% 6% 56% 69% 63% 15% 13% 12%
Virginia 17% 12% 11% 5% 8% 9% 66% 69% 71% 12% 11% 9%
 Has Not Implemented Medicaid Expansion- Republican Governor
Alabama 24% N/A 20% 5% N/A 4% 58% N/A 64% 13% N/A 12%
Florida 27% 17% 20% 5% 4% 4% 50% 64% 60% 18% 14% 16%
Georgia 24% 16% 17% 5% 2% 6% 53% 66% 62% 18% 16% 14%
Idaho 19% N/A 17% 3% N/A 3% 64% N/A 68% 14% N/A 12%
Kansas 14% N/A 14% 6% N/A 2% 69% N/A 73% 10% N/A 11%
Maine 25% N/A 16% 4% N/A 3% 59% N/A 71% 12% N/A 9%
Mississippi 29% N/A 23% 4% N/A 6% 52% N/A 57% 15% N/A 14%
Missouri 19% 15% 13% 7% 2% 3% 60% 74% 73% 14% 9% 10%
Nebraska 13% N/A 13% 2% N/A 4% 74% N/A 75% 10% N/A 8%
Oklahoma 21% N/A 17% 5% N/A 5% 57% N/A 63% 17% N/A 15%
South Carolina 27% N/A 19% 5% N/A 5% 55% N/A 64% 13% N/A 12%
South Dakota 15% N/A 12% 5% N/A 2% 66% N/A 75% 14% N/A 11%
Tennessee 26% N/A 19% 5% N/A 4% 57% N/A 64% 12% N/A 12%
Texas 19% 20% 16% 4% 2% 4% 57% 58% 62% 21% 21% 17%
Utah 13% N/A 11% 2% N/A 2% 71% N/A 76% 14% N/A 11%
Wisconsin 18% 30% 14% 2% 2% 2% 73% 60% 78% 7% 9% 6%
Wyoming 12% N/A N/A 4% N/A N/A 71% N/A N/A 12% N/A N/A
NOTES: Includes nonelderly individuals ages 0-64. Totals may not sum to 100% due to rounding. Other Public includes Medicare, military, and Veterans Administration coverage. MT and LA adopted Medicaid expansion in 2016. N/A indicates lack of geographic area in state.

SOURCE: Kaiser Family Foundation analysis based on the 2015 American Community Survey 1-Year Estimates.

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