St. Louis Post-Dispatch

By: Aaron Griffin and Jen Bersdale

There are people all across Missouri who are struggling to access health care, but the situation is much worse for those living in rural communities and small towns. While about a quarter of Missourians living in metro areas like St. Louis and Kansas City are uninsured, 35 percent of those living in rural areas — the communities throughout most of our state — are uninsured. While the uninsured rate in big Missouri cities fell modestly after the Affordable Care Act was implemented, the rural uninsured rate has barely budged, according to a new report from researchers at Georgetown University [Center for Children and Families] and the University of North Carolina. Compare that to what’s going on in some of our neighboring states. In Arkansas, the rate of uninsured adults in these rural communities fell from 45 percent in 2008-2009 to 22 percent in 2015-2016. In Iowa, it dropped from 27 percent to 15 percent. And in Illinois it fell from 29 percent to 12 percent. Yet here in Missouri, the uninsured rate for this group of rural residents is still stuck at 35 percent. What accounts for the difference? Medicaid expansion.

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