Report: Rural Texas Will Suffer if Congress Cuts Medicaid

For Immediate Release
January 15, 2025
Contact: Peter Clark, [email protected]

Georgetown University study indicates federal Medicaid cuts would have an extreme impact in rural Texas

Austin - Medicaid plays a larger role in providing health coverage to Texas adults in small towns and rural communities than adults in the state’s urban areas, according to a new report by the Georgetown University Center for Children and Families (CCF). The report comes at a time when Congressional leaders are considering making deep permanent cuts to Medicaid health insurance.

The report shows that among Texas adults younger than 65, about 14.3% of those in small towns and rural areas get their health insurance through Medicaid/CHIP, compared to about 7.7% in metro areas. Among seniors (age 65 and up), 21.9% of those living in Texas’ small towns and rural areas were covered by Medicaid compared to 15.1% in urban areas.

In Texas, most adults enrolled in Medicaid coverage are either pregnant women, people with disabilities, or seniors. Because Texas has not implemented Medicaid expansion, uninsured adults in Texas cannot qualify for Medicaid based solely on their income.

“It will be devastating for rural Texas if Congress cuts Medicaid,” said Erin O’Malley, Senior Policy Analyst at Every Texan, a member of the Cover Texas Now coalition. “Congress should be looking for ways to improve health care for children, seniors, pregnant women, and people with disabilities in rural communities rather than pulling the rug out from under them.”

The study also found that one in three Texas children (33.1%) living in small towns and rural areas rely on Medicaid/CHIP for their health insurance.

“Medicaid is critically important to the families and health care systems in rural Texas,” said O’Malley. “Across the state, Medicaid protects families from excessive medical debt and covers a large share of residents in nursing homes, births, and maternal care. Medicaid funding also keeps our rural hospitals running. Many of these institutions would cease to exist without federal funding, leaving thousands of Texans without a way to access care.”

This report primarily relies on data from the Census Bureau’s 2023 American Community Survey (ACS).

The Center for Children & Families (CCF), part of the McCourt School of Public Policy at Georgetown University, is an independent, nonpartisan policy and research center founded in 2005.

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