To the editor:
Poverty rates are generally higher in rural areas than in urban centers. Also, rural Iowans are more likely than their urban neighbors to be self-employed or working for a small business without employer-sponsored health insurance. They are, therefore, more likely to be uninsured or underinsured.
As written, the Affordable Care Act would expand Medicaid eligibility to all adults below 138 percent of the federal poverty level. The U.S. Supreme Court, however, ruled that states could not be compelled to participate in the Medicaid expansion.
That decision means that more than 100,000 Iowans who fall below 138 percent of the federal poverty level, such as a family of three earning less than $26,344 annually, will still struggle to find affordable health insurance if the state declines to participate in the Medicaid expansion.
Medicaid provides a crucial healthcare safety net for those rural residents most in need. And the expansion of Medicaid would bring in several billion dollars from the federal government by 2020, potentially financing the creation of over ten thousands ongoing Iowa jobs. Moreover, expanding Medicaid will help alleviate some of the costs of uncompensated care for the uninsured, reducing premiums for those with private insurance.
Over ten thousand healthcare jobs, lower insurance premiums for the currently insured and access to affordable healthcare coverage for over 100,000 Iowans, many of whom lack coverage today, all speak in favor of expanding Medicaid in the state, for rural Iowa in particular.
John Crabtree
Center for Rural Affairs