That failure to expand is leaving a big dent in budgets of hospitals in some communities, according to a new report by the Georgetown University Center for Children and Families.
Paul Taylor, CEO of the Ozarks Community Hospital system, says Arkansas expanded Medicaid in 2014 and the percentage of uninsured patients being treated has dropped to below 10, but in Missouri the number has increased to between 40 and 45 percent in some emergency rooms “If we hadn't reduced our payroll in Missouri, we were jeopardizing the entire system, so we shrank operations and reduced the services we were providing in the hospital and we laid off a bunch of folks,” says Taylor.
The latest national Gallup poll on health coverage says seven of the ten states that have done the best jobs of getting more people insured have expanded their Medicaid programs.
Jack Hoadley, co-author of the Georgetown University report, says states that have expanded Medicaid have seen major reductions in the amount of uncompensated care delivered by safety-net institutions.
"This is the kind of ripple effect," says Hoadley. "It's not just the patient now comes in and gets a service, or now comes in and is able to pay for the service as opposed to receiving charity care, but the dollars that are saved, or the dollars that are brought in to these institutions, really are used in ways that really fundamentally change the way care is delivered."
Taylor calls the Ozarks Community Hospital system a "living experiment" when it comes to the expansion of Medicaid.
"If it weren't for the positive operating margin we're experiencing in Arkansas, the entire system would be out of business," he says. "The positive operating margin we're experiencing in Arkansas, we're using to subsidize the Missouri operation so we can continue in business."
The report also says health care facilities in Medicaid-expansion states also see growth in new programs, such as expanding access to specialists improving care for all patients, particularly in rural areas.
Public News Service