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Medicaid Ruling Creates Major Budgeting Problem

Karen Minich-Pourshadi, for HealthLeaders Media, July 2, 2012

Nevertheless, several Republican Senators, including those from Missouri, Nebraska, Mississippi, and Idaho, have already declared that their states would likely turn down new federal money to expand Medicaid. One reason cited is the difficulty of picking up their share of the program once the government's portion decreases to 90% of costs. The ruling will likely spark continued political clashes in at least 26 states—primarily those that sued to overturn the law.

"Today's ruling underscores the urgency of repealing this harmful law in its entirety," House Speaker John Boehner, R-Ohio, told the press. While Ohio hasn't announced a decision on adoption of the expanded Medicaid coverage, with a Republican governor in office and a November Presidential election on the horizon, it's quite possible.

A provider view on Ohio's situation comes from Mary Ann Freas, CFO at Southwest General Health Center, a private, not-for-profit, 354-bed facility located in Middleburg Heights, Ohio. "I don't know if we will or won't participate, but I do know that if they don't [opt in], it's going to put more burden onto the safety-net hospitals," she says.

If the state opts not to participate, "the safety-net hospitals that have a great deal of uninsured will lose their disproportionate share and that will hurt. I'm not sure that's something that [the state] can politically get away with."

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2 comments on "Medicaid Ruling Creates Major Budgeting Problem"


David Andrews (7/3/2012 at 9:32 AM)
This article makes a good point. Michigan is faced with covering another 1 million people under expanded Medicaid. I suppose this could be done if the prisons are closed and school funding is cut. Hospitals are covering these people now as a write-off very expensively with no preventive health. Will hospitals start paying the Medicaid premiums to offset the write-offs?

S Harbaugh (7/2/2012 at 3:07 PM)
I am completely amazed that we have so many healthcare "leaders" looking at the issue of Obamacare from a completely myopic, selfish viewpoint of how their individual organizations will benefit or not benefit from the law! What about the concept of Constitutional limitations on federal power? What about the loss of individual liberty? At the end of the day, hospitals are going to saddled with even more federal regulations, reporting requirements, and mandates. No state that is governed by competent leaders is going to willingly sign-up for an expansion of Medicaid when they cannot accurately forecast the increased cost, in addition to having to pay 90% of these costs after 3 years. Rather than being homers for the current administration and not wanting to rock the boat, the AMA and HFMA might want to re-focus their energies on standing up for what is right, rather than for what is expedient.