9 southern states remain Medicaid expansion holdouts

Nine contiguous Southern states are the most steadfast holdouts on expanding Medicaid as part of the Affordable Care Act, according to the Biloxi Sun-Herald. The low health indicators of their residents suggest hospitals in those states could be hit hard financially without participation in Medicaid expansion.

Policymakers in those states--Tennessee, North Carolina, South Carolina, Georgia, Alabama, Mississippi, Louisiana, Texas and Oklahoma--say they can't afford to expand the program, even though the federal government would fully fund expansion between 2014 and 2016, and 90 percent of the costs thereafter.

Moreover, seven of the nine states are considered the unhealthiest in the nation in numerous categories ranging from obesity to infant mortality, the Sun-Herald reported.

"I think it's very foolish from a health perspective, from an economic perspective, for these states to be turning this down," Joan Alker,  co-executive director of the Center for Children and Families at Georgetown University, told the newspaper.

"It's playing politics in the worst sense of the word," she said. "There are no big interests that are against this. The hospitals are for it. The managed care industry is for it. Most of the employer groups are for it."

The poor health indicators and the rising cost of healthcare means prolonged holdouts would hurt the hospitals in those states.

Meanwhile, in Missouri, Gov. Jay Nixon has launched a full-scale lobbying effort, including communicating with federal officials, to get his state lawmakers to approve the expansion, FierceHealthPayer previously reported.

Medicaid expansion could offset $11.1 billion in uncompensated care costs in the Show Me State, which are projected to nearly triple from $1.3 billion in 2011 to more than $3.5 billion by 2019, concluded a report released this week by the Missouri Hospital Association.

For more:
- read the Sun-Herald article
- here's the Missouri Hospital Association report (.pdf)