Rural areas and small towns across America have special problems accessing health care. Our colleagues at the University of North Carolina’s Rural Health Program have tracked the increasing numbers of rural hospital closures around the country. The Rural Health Information Hub is also a great resource on the opportunities and challenges for rural health delivery nationwide.

Of the many health issues facing rural communities, there are few with more impact than Medicaid financing, structure and expansion. Why? Medicaid is especially important in rural areas and small towns of our country. In fact, our research has found that, “Medicaid covers a larger share of nonelderly adults and children in rural and small-town areas than in metropolitan areas; this trend is strongest among children.”

And just this month, research published in The Journal of Rural Health took a hard look at what happens in rural areas in states that have expanded Medicaid. They found Medicaid expansion disproportionately benefited rural communities. Rural areas had higher increases in Medicaid coverage than in urban settings. So, more people had coverage, which is a huge benefit. However, the researchers also concluded that increasing the number of people with health coverage is just a first step for rural areas – improving access and addressing the other health problems people living in rural areas face is also important.

It’s research like this that has convinced the National Rural Health Association that expanding Medicaid coverage in states is one of the four key changes that can help rural providers deliver better and more affordable care in rural America.