Muskie School of Public Service

Rural Americans Face Higher Costs for Health Care

November 27, 2006

Portland, ME: A new study comparing health care spending among rural and urban residents shows that, even when privately insured, rural residents experience higher out-of-pocket costs for health care. The study was recently published as an article in the November/December 2006 Health Affairs-the nation's leading health policy journal.

Researchers at the Muskie School of Public Service at the University of Southern Maine compared spending among rural and urban residents in the U.S who have private health insurance and determined that rural residents are 70 percent more likely to be "underinsured"-or lack adequate coverage.

"This study highlights serious and unique challenges facing rural America," says Erika Ziller, lead author of the Health Affairs article. "Employers, particularly small businesses so common in rural areas, are having to shift more and more health insurance costs to employees. This means that the health care cost burden for rural residents is only likely to get worse."

The study found that while 6 percent of urban residents were underinsured, the rate increases to 10-12% for rural residents, depending on how far they live from an urban area. Rural residents also pay as much as 21% more per year in out-of-pocket costs for their care than people in urban areas, despite having private health insurance.

The results of the study, which was funded by the federal Office of Rural Health Policy, are available in a policy brief entitled "Rural Residents More Likely to be Uninsured" at www.muskie.usm.maine.edu. An abstract of the Health Affairs article is available at http://content.healthaffairs.org/cgi/content/abstract/25/6/1688.

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