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NAPH Chief Warns of 'Disaster' if States Don't Expand Medicaid

Cheryl Clark, for HealthLeaders Media, July 26, 2012

Second, the PPACA sets forth a mechanism by which the Medicaid Disproportionate Share Hospital (DSH) program will be dramatically scaled back. This year the program will send an estimated $10 billion in federal funds to hospitals that treat large numbers of Medicaid uninsured patients, The schedule is to cut $.05 billion in 2014, $.06 billion in 2015 and in 2016, $1.8 billion in 2017, $5 billion in 2019 an $4 billion in 2020, almost half of its current amount.

With these converging forces squeezing the healthcare safety net, HealthLeaders Media asked Bruce Siegel, MD, President and CEO of the National Association of Public Hospitals and Health Systems, for his reaction.

HLM: In your statement, you've estimated that between 4 million and 13.8 million people who would have been eligible for Medicaid under the healthcare reform law's expansion provisions happen to live in states that have decided against that expansion, as the Supreme Court ruled they could. How can these issues be resolved?

Siegel:  We take the governors very seriously. We believe there are 30 states that could potentially not expand Medicaid, the 26 in the lawsuit plus four others who have made statements. We take that very seriously. This is not a joke and we don't think it's a bluff. These states have a record of turning down federal money. Florida turned down stimulus funds.  So though you hear people saying, 'Oh, it will be okay at the end; they'll expand.' We're not convinced of that at all.

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