Op-Ed: Medicaid: The Load-Bearing Beam of Rural Healthcare Access

SV Herald 02-18-2025 OpEd Medicaid the load bearing beam of rural healthcare access

Dennis Walto Chiricahua Health Foundation

As Congress eyes cost savings in the health sector, the focus will be on Medicaid. But as the gaze turns to action, we need to be reminded that changes to Medicaid will negatively impact rural America in more ways than just healthcare. In Cochise County, Arizona, and rural communities across the country, Medicaid not only serves as the cornerstone of healthcare access by providing health insurance to children and families who would otherwise not have it, Medicaid is also the load-bearing beam that supports the entire structure of community wellbeing.

Further, as urbanization continues to pull families from rural communities, and workforce pressures attract health care providers away to urban centers, the entire healthcare infrastructure may be compromised if cuts to Medicaid are enacted. Medicaid’s importance in rural areas, where healthcare resources are often scarce, cannot be overstated. According to the Kaiser Family Foundation, across the country, rural residents are more likely to rely on Medicaid than their urban counterparts, with 24% of rural populations enrolled as compared to 20% in urban areas.

In Arizona, rural counties have higher Medicaid enrollment rates per capita due to lower incomes, fewer employer-sponsored insurance plans, and a higher burden of chronic disease. In Cochise County, there is only one primary care physician for every 1,680 individuals, where the top performing counties have one for every 1,010 individuals. Patient-to-dentist ratios and patient-to- behavioral health professional ratios are also high. These numbers make Cochise County a health professional shortage area (HPSA) for medical, dental, and behavioral health providers.

Despite these challenges, Chiricahua Community Health Centers, Inc. (Chiricahua), the area’s only Federally Qualified Health Center, is among the top ten employers in Cochise County. Chiricahua’s payroll provides $1.3 million dollars to county families every two weeks. By offering a reliable and consistent revenue source, Medicaid funding affords organizations like Chiricahua the ability to both attract health professionals to our community and open new health centers that can accept all payment options – including private insurance. Without Medicaid, which amounts to about 60% of our patient revenue, we will be hard pressed to bring additional healthcare providers or services to our rural communities or even maintain the clinical presence we currently have.
And we’re not alone, according to Medicaid.gov, more than 72 million Americans, or approximately 20% of the U.S. population – are currently enrolled in Medicaid insurance plans. In Arizona, Medicaid is administered through the Arizona Health Care Cost Containment System (AHCCCS), which serves more than 2.5 million people. In Cochise County, approximately 23% of the population is enrolled in Medicaid, almost one-in-every-four people.

In Arizona, AHCCCS provides doctor visits, dentist visits, immunizations, hospital services, emergency care, pregnancy care, and mental health treatment. This comprehensive coverage ensures that residents in rural areas like Cochise County have access to essential healthcare services despite geographical and financial challenges. But the utilization numbers are not the complete story.
In rural regions like Cochise County, Medicaid is more than just a healthcare program; it is the load-bearing beam that supports the entire wellness structure of our community. It is both healthcare and economy – its extensive coverage and integration with other social services make it an indispensable part of whole-person care. As budget discussions and policy debates continue, it is crucial to recognize and preserve Medicaid’s role in sustaining the health and well-being of children and families in rural Arizona, and rural America.