"We tried to find a way to provide access… and not continue to impose the cost on ratepayers for the uncompensated care," said NH state Sen. Nancy Stiles, (R-Hampton). She says one of the prime benefits to hospitals is that they will receive a higher rate of reimbursement from health policies on the exchange than they would have received through expansion of the state's existing Medicaid program.
Two dozen states have yet to expand Medicaid to income-eligible adults, and hospitals are feeling the pinch, according to Brendan Saloner, PhD, lead author of a perspective piece on Medicaid expansion published in the New England Journal of Medicine on March 27. He says one way the federal government is paying for healthcare reform efforts under the Patient Protection and Affordable Care Act is through cuts to the program Washington had previously used to help hospitals pay for uncompensated care, the Disproportionate Share Hospital reimbursement program.
Cuts to DSH "went into effect under the assumption the states would expand Medicaid," Saloner wrote, adding that hospitals serving low-income populations in states without Medicaid expansion are taking a heavy blow. "That causes a lot of financial strain."
In Missouri, which is politically gridlocked over Medicaid expansion, the state hospital association is leading the charge to expand the program.