Document Type

Policy Brief

Publication Date



Medicare Expansion, Affordable Care Act, Rural Health, MRHRC, health system reform


In this brief, researchers from the Maine Rural Health Research Center (University of Southern Maine, Muskie School of Public Service) present findings from a SHARE-funded evaluation of the rural implications of Medicaid expansion under the ACA.

The authors examine the following issues:

  • The extent to which prior public health insurance expansions have covered rural populations
  • Whether rural residents who are expected to be newly eligible for Medicaid in 2014 differ from their urban counterparts
  • The extent to which rural individuals might differentially benefit from the ACA Medicaid expansion in light of the expansion becoming optional
  • Whether rural enrollees are likely to have adequate access to primary care

The evaluation is based on the 2007-2011 panels of the Medical Expenditure Panel Survey (MEPS), linked with state-level Medicaid policy data and county-level primary care provider data.


SHARE is a Robert Wood Johnson Foundation (RWJF) grant program that funds rigorous research on health reform at the state level, including state implementation of national reform.

Funding Organization

Robert Wood Johnson Foundation (RWJF)



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