A new study by the Urban Institute says that not expanding Medicaid will cost hospitals in Kansas and Missouri more than $9 billion over a 10-year period. The analysis from the nonpartisan research organization pegs the loss to Kansas hospitals at $2.6 billion between 2013 and 2022. Missouri hospitals would forfeit $6.8 billion over the same period. Hospitals in the 24 states that have so far declined to expand Medicaid to cover more low-income adults would lose a combined total of $167.8 billion. The report says: "First-quarter earnings reports from several interstate hospital chains described major differences between states that expanded Medicaid – where hospital finances improved as uncompensated care fell and Medicaid revenue rose, both by significant amounts – and nonexpanding states, where hospital finances worsened, with uncompensated care and self-pay patient caseloads rising and Medicaid revenue failing."