Rural Health Policy Project

Medicaid is Vital to Seniors in Small Towns and Rural Areas

Most of our research is focused on children and families, but as we looked at Medicaid use in small towns and rural areas for our recent report, we were curious what the data showed for seniors. After all, grandparents and older relatives are an important part of most families, and their health and wellbeing is essential to us all.

Using the same data sources, we put together a short snapshot on Medicaid’s role for seniors in small towns and rural areas. What we found is that Medicaid is an important lifeline for older adults (ages 65+) supplementing their Medicare by providing long-term care services or helping them meet other health care needs not fully covered by Medicare.

Unlike with children and non-elderly adults, we found that the percent of seniors relying on Medicaid in small towns and rural areas declined slightly during the examined period from 18 percent in 2008-2009 to 15 percent in 2014-2015.

Nationally, there is no observable difference between the percent of seniors receiving Medicaid in small towns and rural areas as compared to metropolitan areas, but there are state exceptions to this finding. The seven states where Medicaid is disproportionately important to seniors living in small towns and rural areas are: Missouri, Alaska, South Carolina, Mississippi, Alabama, Arizona, and Maine.

Nineteen states are above the national average (15 percent) for the share of seniors who rely on Medicaid in small towns and rural areas. Alaska has the highest rate in the country with 27 percent of seniors relying on both Medicaid and Medicare, and Mississippi follows with 25 percent. Maine, Louisiana, South Carolina, Alabama, and Kentucky all have at least one-fifth of their seniors in rural areas relying on Medicaid. As a result, cuts to Medicaid will have a disproportionate impact on rural health providers and populations in these states.

Across the country, these findings are significant not just for older adults and their families, but also for community institutions. Medicaid is the No. 1 payer for patients at 62 percent of nursing homes nationwide. The program also supports older adults who want to remain in their homes or live with their families.