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Member Research & Reports

Member Research & Reports

WashU, Iowa: Health Insurance Premiums Rising Faster in Rural Marketplaces

Premiums for health insurance policies in marketplaces authorized by the Affordable Care Act grew more from 2015-16 in rural areas than in urban areas, according to research from the Brown School at Washington University in St. Louis and the University of Iowa College of Public Health.

[Photo: Dr. Abigail Barker]

Researchers studied data on 2016 premiums from the Centers for Medicare & Medicaid Services, as well as from state insurance commissions and online consumer portals. They found that premiums had increased disproportionately in rural areas. The data differed from previous years, when urban and rural premium increases did not show a consistent pattern.

Another key finding of the study was that in 2016, urban counties continued to have more firms offering health insurance coverage through the marketplaces, which may have factored into the differences in premiums.

Because subsidies were not taken into account, the results don’t reflect the differences in costs to consumers. But the differences are still cause for concern, the authors conclude.

“Policymakers will need to address the rural/urban differential, if it continues to propagate, to mitigate any adverse effects on people living in rural areas,” wrote lead author Dr. Abigail Barker of the Brown School.

The brief was published in June by the Center for Rural Health Policy Analysis at the Rural Health Policy Research Institute. Other authors include Dr. Timothy McBride, professor at the Brown School; Leah M. Kemper of the Brown School; and Dr. Keith Mueller, professor at the University of Iowa.

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