In states that chose to expand Medicaid, rural hospitals gained significant revenue, while urban hospitals did not appear to be greatly affected. (Photo: iStock)

Rural hospitals are hurting in states that chose not to embrace the Affordable Care Act’s expansion of Medicaid.

The expansion, which was originally crafted to be mandatory but was rendered optional by a Supreme Court decision, was funded entirely by the federal government for the first several years and will be 90 percent federally-funded in the long-run. The expansion enables states to raise the eligibility for Medicaid to all households below 133 percent of the federal poverty level.

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Jack Craver



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