Arkansas No. 1 in Percentage of Kids in Rural Areas Enrolled in Medicaid, CHIP

September 5, 2023


Elizabeth (Izzy) Montgomery, MPA
Policy Analyst


ACHI Communications

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Arkansas has a higher percentage — 65% — of children in rural areas enrolled in Medicaid and the Children’s Health Insurance Program (CHIP) than any other state, according to an analysis by the Georgetown University Center for Children and Families.

The center has developed a series of interactive maps showing rates of Medicaid coverage for non-elderly adults and children by county, based on data from the U.S. Census Bureau’s American Community Survey. Nationally, data compiled by the center show that Medicaid/CHIP) coverage rates as of 2020-21 were higher in rural areas compared to urban areas for both children and non-elderly adults. Regionally, Southern and Southwestern states have the highest Medicaid/CHIP coverage rates for both children and non-elderly adults.

Key Arkansas Findings From the Analysis

  • In urban counties (population of 50,000 or more):
    • Half of all children (50%) are covered by Medicaid/CHIP.
    • Fewer than 1 in 5 non-elderly adults (17%) are covered by Medicaid.
  • In rural counties (population under 50,000):
    • Sixty-five percent of children — more than in any other state — are covered by Medicaid/CHIP.
    • Nearly a quarter (24%) of non-elderly adults are covered by Medicaid.
  • Urban-versus-rural comparison:
    • Children’s Medicaid/CHIP coverage ranges from a low of 40% in Benton and Saline counties to a high of 74% in Jackson County — the greatest disparity of any state.

Jackson County is in the top 20 rural counties nationally for Medicaid/CHIP coverage of children. The county in Arkansas with the second-highest Medicaid/CHIP coverage rate for children is Woodruff with 72%. Medicaid/CHIP covers 70% percent of children in Chicot, Crittenden, Phillips, and Stone counties.

    Medicaid coverage rates for non-elderly adults in Arkansas range from 10% in Benton County to 35% in Phillips County. Other counties where non-elderly adult Medicaid coverage is greater than 30% are Lee, St. Francis, and Stone.

      Impacts of Pandemic, Medicaid Eligibility Redeterminations

      Medicaid/CHIP enrollment in Arkansas grew significantly during the COVID-19 pandemic, reaching nearly 1.2 million enrollees before the state began redetermining eligibility in April. Prior to the pandemic, there were approximately 900,000 Arkansans enrolled in Medicaid.

      By the end of July, 301,837 Arkansans had been disenrolled from Medicaid since April, with children accounting for roughly a third of those disenrollments (see the April, May, June, and July Department of Human Services’ unwinding reports for monthly disenrollment figures). Total Medicaid/CHIP enrollment as of July 31 was 915,926.

      However, the Arkansas Department of Human Services has stated that Arkansas is not among the states asked to pause disenrollments by CMS.

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