Out-Of-Pocket Health Spending And The Rural Underinsured

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Adolescent, Adult, Female, Financing, Personal, Health Care Surveys, Health Expenditures, Humans, Male, Medically Uninsured, Middle Aged, Multivariate Analysis, Rural Health Services, United States, Cutler Institute, Population Health and Health Policy, USM Aging Initiative, Health and Wellness

Publication Title

Health Affairs (Project Hope)


Multiple studies have documented higher uninsurance rates among rural compared to urban residents, yet the relative adequacy of coverage among rural residents with private health insurance remains unclear. This study estimates underinsurance rates among privately insured rural residents (both adjacent and nonadjacent to urban areas) and the characteristics associated with rural underinsurance. We found that 6 percent of privately insured urban residents were underinsured; the rate increased to 10 percent for rural adjacent and 12 percent for rural nonadjacent residents. Multivariate analyses suggest that rural residents' underinsurance status is related to the design of the private plans through which they have coverage.