The looming possibility of federal cuts to Medicaid would hit rural areas in the region particularly hard, according to a study by the Georgetown University Center for Children and Families (CCF).
“Rural, small town and urban areas form the backbone of Pennsylvania, and Medicaid plays a critical role in ensuring access to healthcare for these communities,” said Becky Ludwick, vice president of public policy. “We know Congress is considering enormous funding cuts to Medicaid in the year ahead, and this new report confirms how disastrous this would be for children, pregnant women, families, and seniors. Pennsylvania relies on federal Medicaid funding to thrive.”
According to data from the report, in 2023, the total Medicaid and CHIP coverage in McKean County was at 24%; the average for rural areas in Pennsylvania was 22.6%. Elsewhere locally, Elk County was below average at 20.4%, Potter County was the same as the state rural average, and Cameron County was above average at 24.3%
In 2023 in New York, where the average for rural areas was 34.5%, Cattaraugus County was at 36% and Allegany County was at 35.4%.
According to the report, “Non-elderly adults and children in small towns and rural areas are more likely than those living in metro areas to rely on Medicaid/CHIP for their health insurance. As a consequence, reductions in federal Medicaid funding being contemplated in Congress are more likely to cause greater harm to rural areas and small towns than metro areas.”
The report found that in Pennsylvania, adults and seniors living in rural areas and small towns are more likely than those living in metro areas to rely on Medicaid for their health insurance.
Findings included more than 37 percent of children in Pennsylvania’s small towns and rural areas rely on Medicaid/CHIP for their coverage, compared to nearly the same percentage (38 percent) of children in metro areas.
In New York, about one-third of non-elderly adults living in small towns and rural areas are covered by Medicaid — 33.9%.
“Large reductions in federal Medicaid funding would put the residents of small towns and rural communities and their health care systems at serious risk,” the report noted.
Rural residents already face challenges accessing health services, with rural hospitals closing or combining with larger facilities. Provider shortages, transportation issues and lower incomes for residents present significant challenges already, the study noted.
Among Pennsylvania adults younger than 65, about 20 percent of those in small towns and rural areas get their coverage through Medicaid/CHIP, compared to about 17 percent in metro areas.
Among seniors (age 65 and up), 17 percent of those living in Pennsylvania small towns and rural areas were covered by Medicaid compared to 15 percent in urban areas.
“Medicaid is critically important to the families and health care systems in Pennsylvania,” said Ludwick. “Across the state, Medicaid protects families from excessive medical debt and covers a large share of residents in nursing homes, births and maternal care. Medicaid funding also keeps our rural hospitals running — many of these institutions would cease to exist without federal funding, leaving thousands of Pennsylvanians without a way to access care.”
The study noted similar findings.
“Large cuts to Medicaid currently being contemplated by Congress pose very severe threats to rural communities,” the report stated. “Hospitals and other providers in rural communities are already operating on tighter margins and disproportionately rely on Medicaid for their patient revenues. Families and non-elderly adults in rural areas rely on Medicaid for their health insurance at higher rates than those living in metro areas, underscoring that large cuts will have dire consequences for communities that are already struggling.”
For the full report, as well as interactive maps featuring a county-level breakdown of Medicaid coverage, visit Georgetown’s website. This report primarily relies on data from the Census Bureau’s 2023 American Community Survey (ACS).
