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ACA at 10 Days of Action: Health Care For Rural Americans

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March 17, 2020
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Ahead of the 10th anniversary of the passage of the Affordable Care Act (ACA) on March 23, Protect Our Care is holding 10 days of action to raise awareness of the most critical components of the law which has improved the lives of millions of Americans. Working with partner organizations and health care advocates, Protect Our Care will highlight a different aspect of the law each day while making clear what’s at stake if the Trump administration is successful in overturning the law through the courts.  

“The Affordable Care Act has been an incredibly positive force for Americans over the last 10 years, especially for rural Americans who have traditionally experienced higher rates of uninsurance and barriers to coverage,” said Protect Our Care Executive Director Brad Woodhouse. “Over the course of these 10 days of action, Protect Our Care will remind Americans how the ACA has improved the lives of millions while making clear that President Trump and Republicans’ lawsuit to overturn the law poses an existential threat to Americans’ health care.” 

Days of Action: Day 4 of 10 focuses on Health Care For Rural Americans. To learn more about our days of action, visit our website.

The Affordable Care Act Led To Coverage Gains In Rural America 

Medicaid Is A Lifeline For Rural Hospitals

  • The ACA led to a $12 billion reduction in uncompensated care costs. Between 2013 and 2015, hospitals’ uncompensated care costs decreased by $12 billion, or roughly 30 percent. The majority of this reduction was concentrated in states that chose to expand Medicaid. 
  • 430 rural hospitals are at a high financial risk of closing. This represents roughly 21 percent of the country’s rural hospitals. 
  •  120 rural hospitals have closed since 2010. The vast majority closed in states that had not expanded Medicaid at the time of the hospital closure.

The ACA’s Medicaid Expansion Plays A Central Role In Fighting The Opioid Crisis

  • More than half of people with an opioid use disorder earn incomes below 200 percent of the federal poverty line.
  • In 2014, Medicaid paid for 25 percent of all addiction treatment nationwide.
  • It is estimated that Medicaid expansion covers four in ten people with an opioid use disorder.
  • Among those with opioid addiction, people covered through Medicaid are nearly twice as likely as those with private insurance to receive treatment. In 2017, 44 percent of people who had substance use disorders received treatment when they were covered through Medicaid, significantly higher than the 24 percent of those privately insured who received treatment and 32 percent of those who were uninsured and received treatment.
  • Medicaid expansion has reduced unmet need for substance use treatment by more than 18 percent. Recent research finds that Medicaid expansion reduced the unmet need for substance use treatment by 18.3 percent.
  • Medicaid expansion may have saved more than 8,000 people from fatal opioid overdoses. A recent study found that Medicaid expansion prevented as many as 8,132 deaths in the 32 states that expanded Medicaid between 2014 and 2016.
  • The uninsured rate for opioid-related hospitalizations in Medicaid expansion states dropped by 79 percent. In expansion states, the uninsured rate for opioid-related hospitalizations dropped from 13.4 percent in 2013 to 2.9 percent in 2015. Non-expansion states only saw a 5 percent decline over the same period. 

Republicans Want To End Medicaid Expansion Through Their Lawsuit To Overturn The ACA

  • Seventeen Million People Enrolled Through Medicaid Expansion Could Lose Coverage.
  • Access To Treatment Would Be In Jeopardy For 800,000 People With Opioid Use Disorder. Roughly four in ten, or 800,000 people with an opioid use disorder are enrolled in Medicaid. Many became eligible through Medicaid expansion.
  • Key Support For Rural Hospitals Would Disappear, leaving hospitals with $9.6 billion more in uncompensated care. 
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