Medicaid Provides More Access to Health Coverage for Rural Communities than Metro Areas Across California

Fifty-Four Percent of all Children in Rural Areas and Small Towns Rely On Medicaid and California’s Children’s Health Insurance Program

For Immediate Release

Adults and children in small towns and rural areas in California rely on Medicaid and the Children’s Health Insurance Program (CHIP) – collectively known as Medi-Cal in California – more than those in metropolitan areas, according to a new report released today by the Georgetown University Center for Children and Families and the University of North Carolina NC Rural Health Research Project.

The report, “Medicaid in Small Town America: A Lifeline for Children, Families and Communities,” finds that 54 percent of children in rural areas and small towns in California receive health coverage through Medicaid and CHIP, compared to 44 percent in urban areas. For adults, 28 percent in non-metro areas are covered by Medicaid compared to 21 percent in metro areas.

“Medicaid provides critical access to life-saving treatment and protection from rising health care costs to many children and families living in small towns and rural America,” said Joan Alker, Executive Director of the Georgetown University Center for Children and Families. “Cuts to Medicaid and other health care programs would take those protections away from many and risk financial ruin, denial of health care, or both.”

The report also found the Affordable Care Act’s Medicaid expansion is having a disproportionately positive impact on small towns and rural areas in California. Across the state, the rate of uninsured adults in these areas decreased from 30 percent to 14 percent between 2008/09 and 2014/15. California ranks fourth nationwide in the greatest decline in uninsured adults in non-metro areas.

For children, the data show a clear correlation between increases in Medicaid and CHIP coverage and decreases in the rate of uninsured kids in small towns and rural areas. In California, the rate of uninsured children in these areas dropped from 10 percent to 4 percent between 2008/09 and 2014/15.

“When kids and families have health insurance, the entire community is strengthened,” said Pete Manzo, President & CEO of United Ways of California. “Medicaid is critical to making health care affordable for families. ​More access to health coverage can mean fewer visits to the ER, less uncompensated care and more people getting—and staying—healthy. We must not turn our backs on the progress we’ve made in getting our children the health coverage they need to succeed.”

“Given how critical Medi-Cal is for kids and families in rural areas, Congressional representatives from those areas especially ought to be strengthening Medicaid, not voting for proposals that would cut billions in federal Medicaid funds for California,” said Ted Lempert, President of Children Now.

The report primarily relies on data from the Census Bureau’s American Community Survey (ACS). The full report along with interactive maps showing a county-by-county breakdown on health care coverage data are available at:


The Children’s Defense Fund-California (CDF-CA) is a state office of the Children’s Defense Fund, a national child advocacy organization founded by Marian Wright Edelman that has worked relentlessly for over 40 years to ensure a level playing field for all children. With offices in Los Angeles, Oakland, Sacramento and Long Beach, CDF-CA champions policies and programs that lift children out of poverty, ensure all children have access to health coverage and care and a quality education, and invest in our justice-involved youth.

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Mike Odeh
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