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State Battles over Medicaid Expansion Heating Up

Christopher Cheney, for HealthLeaders Media, April 3, 2014

In the Show Me State, the Missouri Hospital Association has joined forces with the Missouri Chamber of Commerce and Industry to break the political gridlock over Medicaid expansion.

"What's certain is that Missouri will need a state-specific solution," David Dillon, vice president of media relations at the MHA, said in an email last week. "We have at least two 'Medicaid reform and transformation' bills in the legislature that could provide a path forward. The question is whether lawmakers will keep the bills moving and provide an appropriation for the program if common ground can be found."

Alex Feldvebel, NH deputy insurance commissioner, says there are compelling reasons for other states to follow the Granite State's lead. "We can't speak for other states, but we know that in New Hampshire, Medicaid expansion will address the coverage chasm for those people below 133 percent of the federal poverty level."
He cites "many benefits" to Medicaid expansion:

  • It promotes efficient use of a state's health care resources. Giving more people secure coverage can lower overall costs by moving patients to more cost-effective care settings such as primary care offices rather than emergency rooms.
  • It may improve the average health status in the commercial insurance risk pool.
  • Many hospitals write off any payment liabilities from patients earning less than 200 percent of the federal poverty level. A Medicaid expansion would decrease the number of self-pay patients and reduce collection efforts.
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