Approximately 66 million people – about 20% of the U.S. population – live in rural areas, where Medicaid covers 1 in 4 adults (a higher share than in urban areas) and plays a large part in financing health care services. In rural communities, Medicaid covers nearly half of all births and one fifth of inpatient discharges. The Congressional Budget Office (CBO) estimates that the enacted reconciliation package would reduce federal Medicaid spending by an estimated $911 billion over ten years, and result in 10 million more uninsured people nationwide.