Enrollment by rural Americans in Health Insurance Marketplaces established by the federal government under the Affordable Care Act grew to about 1.4 million in 2016, according to new research by the Brown School at Washington University in St. Louis.

The researchers produced enrollment estimates using available data from the 38 states whose marketplaces are federally facilitated or supported and compared marketplace enrollment rates in rural and urban areas.  The researchers found a significant enrollment differential across states, with urban enrollment rates often exceeding rural.  However, enrollment rates were substantially higher in rural than in urban areas in Hawaii, Illinois, Michigan, Montana, Maine, Nebraska, Wisconsin and Wyoming.

“Monitoring annual enrollment rates provides a gauge of how well state outreach and enrollment efforts are proceeding and helps identify states with strong non-metropolitan enrollment as models for other states to emulate,” wrote the report’s lead author, Dr. Abigail Barker of the Brown School.

The brief was published in January 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; Kelsey Huntzberry and Leah Kemper of the Brown School; and Dr. Keith Mueller, Professor at the University of Iowa.

http://www.public-health.uiowa.edu/rupri/publications/policybriefs/2017/Rural%20Enrollment%20in%20Health%20Insurance%20Marketplaces%20by%20State%202016.pdf