Adding to the case in favor of expanding Medicaid limits, the Missouri Hospital Association recently announced that in 2011, for the first time, the cost to hospitals of caring for uninsured patients topped $1 billion. The number was $1.1 billion to be exact! The $1.1 billion tab was 22 percent higher than what Missouri hospitals provided in 2010. Of the 2011 amount, $622.8 million was charity care provided by the association’s 129 participating hospitals. The remaining amount was bad debt.
Hospitals are currently able to recoup some of that amount from the federal and state governments, which pay “disproportionate share” compensation to hospitals which serve high numbers of poor and uninsured patients. But those payments are expected to be phased out under the Affordable Care Act as more people gain insurance either through new state marketplaces or from expanded Medicaid limits.
The hospital association anticipates that Missouri hospitals will lose $3.3 billion in disproportionate share payments through 2020. They will still have to care for uninsured sick people in their emergency rooms, however.
GVMH currently provides, on average, $250,00 per month in uncompensated care. We turn no one away regardless of ability to pay, not only in the ED setting but for every service we provide. We have a very liberal financial assistance program and that’s because part of our mission is to provide care to our community.
As I mentioned before hospitals are currently provided some offset to uncompensated care through disproportionate share payments which are intended to assist hospitals in meeting the needs of the uninsured in their communities. When these federal payments go away, many hospitals in Missouri will no longer be able to make ends meet and will be forced to close their doors. The expansion of Medicaid would help offset the loss of the federal aid to care for the uninsured and hospitals would be better able to weather the storm.
It’s easy to think that I’m biased when it comes to Medicaid expansion, and to some extent I am, but the truth is the federal government made the rules and GVMH, like all Missouri hospitals, is forced to live, and die, by them. The rules are only fair when they apply to every state equally.