Working-age adults living in small towns and rural areas are more likely to be Medicaid than their city counterparts, creating a dilemma for Republicans looking to cut their health care programs deeply.

About 72 million people – Nearly 1 in 5 people in the US – Medicaid registered, providing health insurance for low-income and disabled people, and jointly funded by the federal and state government. Black, Hispanic and Indigenous people are It is expressed disproportionately On the roll, and More than half of Medicaid recipients He’s a person of color.

Nationwide, 18.3% of adults aged 19 to 64 live in small towns and rural areas, but are registered compared to 16.3% in the metro area. According to recent analysis By Georgetown University Center for Children and Families.

In 15 states, at least a fifth of working-age adults in small towns and rural areas are covered by Medicaid, while more than a third is covered in two states, Arizona and New York. Eight of the 15 states voted for President Donald Trump.

The 26 Republicans in the US home represent districts where Medicaid covers more than 30% of the population. Recent analysis by the New York Times. Many of these districts have considerable rural people, including Louisiana House Speaker Mike Johnson’s Fourth Congressional District.

California Republican Rep. David Valadao is opposed to potential cuts as the Central Valley district is more than two-thirds of Hispanics and 68% of residents are registered with Medicaid.

“I’ve heard from countless constituents who have taught me that the only way I can afford healthcare is through programs like Medicaid. I don’t support the final settlement bill where I risk leaving them,” Baradao told the members to the House in a recent floor speech.

American Republicans are trying to Cut federal budget by 2 trillion dollars When they are seeking $4.5 trillion in tax cuts. GOP leaders have directed to find a House Energy and Commerce Committee that oversees Medicaid and Medicare Save $880 billion.

Trump ruled out Medicare cuts covering seniors. Medicaid is leaving Medicaid as another program large enough to provide the savings they need. But targeting that population has disproportionate impacts on small towns and rural areas where Republicans are certainly on the list.

Furthermore, hospitals and other healthcare providers in rural communities rely heavily on Medicaid. Many rural hospitals struggle Nearly 200 people are closed Or we’ve expanded our services significantly over the past 20 years.

Before the Affordable Care Act was enacted in 2010, there were far fewer Medicaid Roll working-age adults. The programme mainly covered children and their caregivers, people with disabilities and pregnant women. However, under the ACA, states are allowed to expand Medicaid to cover adults, accounting for up to 138% of federal poverty levels. Approximately $21,000 One person’s year. As an incentive to expand, the federal government covers 90% of its costs. Traditional Medicaid population.

There was last year Approximately 21.3 million Those who received compensation through Medicaid expansion.

One of the GOP’s cost-cutting ideas is to reduce the federal unity of its population to what the Fed gives the nation a nation to the traditional Medicaid population. This will cut federal spending by $626 billion over a decade. According to recent analysis Health Research Group, KFF.

Nine States – Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah, Virginia – Legal Triggers When the Fed reduces its share, Medicaid expansion will automatically end. Three other states, Idaho, Iowa and New Mexico, require other cost-saving measures.

“States cannot cover these shortages,” said Jennifer Driver, senior director of reproductive rights at the State Innovation Exchange, a left-leaning nonprofit advocating for state legislative issues. “We’re not cutting costs. It’s putting people at real risk.”

the study It shows The expansion of Medicaid has improved health care for a variety of issues, including family planning, HIV care and prevention, and postnatal health care.

Another idea is to require healthy Medicaid recipients to work. It affects an average of 15 million subscribers each year, with 1.5 million people losing their federal funds and becoming federal government Savings of about $109 billion over a decade.

In the massive state of North Carolina, which has triggering methods, Medicaid has around 3 million people. 640,000 of them Eligibility is based on the state expansion program. Approximately 231,000 I live in a rural county of an extended subscriber. Black residents make up 36% New Registrars Based on Expansion of State Eligibility twenty two% of the state’s population.

Brandy Harrell, chief of staff at the Health Leadership and Innovation Foundation, a Carrie, North Carolina-based advocacy group, is an advocacy group focusing on rural issues, saying the proposed Medicaid cuts “deepen existing gaps” between whites and blacks and urban and rural residents.

“It will have a major impact on working families by reducing access to essential health care, increasing financial burdens and putting children’s health at risk,” Harrell said. “Reductions could lead to more medical debt and could reduce health outcomes in our state.”

The two North Carolina legislators represent rural areas on the western and North Carolina coast, each with US vice president and Greg Murphy, who are around 30% of Medicaid members.

FOXX supports GOP budget priorities with social media posts. Murphy, a doctor and co-chair of GOP Doctors Caucus, focuses his statement on taking care of what he says abuse Medicaid system fraud.

However, last week, Josh Stein, the Democratic government of North Carolina. I sent a letter The state’s rural communities disproportionately rely on Medicaid, overturning the already fragile landscape of rural hospitals in the state, and both parties to the leaders of the House and Senate.

“The damage to the North Carolina health care system, especially the rural hospitals and providers, is devastating, not to mention those who can no longer afford access to health care,” Stein writes.

In Nebraska, 27% of residents live in rural areas, and state legislators are already rushing to compensate for federal Medicaid funding cuts.

Dr. Alex Dwalk, a family medicine physician who works at the Omaha Health Clinic, which serves low-income and uninsured people, said the lack of healthcare options in rural Nebraska has already hurt residents. He has one patient who drives up to three hours from his rural community to the clinic.

“It’s not a bad thing for marginalized communities, but it’s a bad thing for marginalized communities because it was already bad for them,” Dworak said of the proposed Medicaid cut. “It’s going to be a complete disaster.”

Stateline Reporter Nada Hassanein and Stateline’s Barbara Barrett contributed to this report. You can contact Scott S. Greenburger [email protected].

Stateline It is a nonprofit news network that is part of the state newsroom and supports a coalition of grants and donors as a public charity of 501C(3). Stateline maintains editorial independence. For questions, please contact editor Scott S. Greenberger. [email protected].