A report has found that the cuts to Medicaid proposed in the Republican health care bill supported by President Donald Trump would hit rural America the hardest.
The Washington Post noted that uninsured rates in rural areas had declined 11 percent since the Medicaid expansion under Obamacare; that decline outpaced that of urban areas, where the decline was 9 percent. Rural areas in states which did not sign up for the expansion of Medicaid saw a 6-percent decline in uninsured rates.
This could cause problems for Trump, who received strong support from rural areas and small towns during the 2016 election.
"The role of Medicaid in small towns and rural areas grew considerably between 2008-2009 and 2014-2015 and contributed to a reduction in the total number of uninsured," the report from Georgetown University states, according to the Post.
The American Health Care Act, passed by the House in May, would cut more than $800 billion in funding for Medicaid over the next decade. According to independent projections, 23 million people would lose coverage under its provisions.
The Senate has not yet started debate on the bill.
In 2015, Medicaid provided coverage for 45 percent of children and 16 percent of adults in small towns and rural areas, compared to 38 percent and 15 percent respectively in urban areas.
The report also found that 13 states have more than 20 percent of their adults enrolled in Medicaid. Arizona topped that list with 34 percent.
In 14 states, Medicaid covers more than 50 percent of children; in Arkansas and Mississippi, rates rise to more than 60 percent.
"There is no doubt that children and families in small towns would be disproportionately harmed by cuts to Medicaid," Joan Alker, the executive director of the Center for Children and Families at Georgetown University, told The Times-Picayune.
On June 6, Medicaid enrollees and their supporters held "Don't Cap My Care" rallies in cities across the country. Approximately 400 people rallied at Capitol Hill in Washington.
"It's frustrating and scary," said Cindy Jennings, who attended a protest. "I need to stay healthy to care for him," she added, referring to her son, who is disabled.
Senate Democrats have indicated they will resist plans to cut Medicaid and emphasize the impact it would have on rural areas.
"Usually in health care, you're providing health care; you're improving it," said Democratic Sen. Bob Casey, according to the Charlotte Observer. "This is a scheme to give very wealthy people even more. It's repeal and decimate."
Republicans have countered that the cuts do not mean the end of Medicaid, since states will receive the powers to maintain and fund Medicaid programs as they see fit.