The amount of charity care provided by hospitals in Kentucky plummeted in recent years, although it may only be a temporary situation.
Hospitals in the Bluegrass State last year has the lowest rates of charity care they had seen in years. In fact, the amount was 77 percent lower than it was in 2012, before the increase in insurance coverage from the Affordable Care Act began to take hold, according to data from Foundation for a Healthy Kentucky.
In 2012, charity care totaled about $2.4 billion and then rose slightly the following year. But it dropped by more than half in 2014, to $942 million, and then slid to $552 million in 2015.
“Thousands more Kentuckians had insurance in 2015 than in 2012, and that led to a huge drop in the value of the charity care hospitals provided,” said Ben Chandler, chief executive officer of the Foundation for a Healthy Kentucky, in a statement. “Charity care and uncollected bills comprise a significant portion of uncompensated care provided by Kentucky hospitals, and hospitals in other states that, like Kentucky, have expanded Medicaid also have seen large decreases in the charity care.”
Nationwide, Medicaid expansion has helped to cut down on charitable care expenditures, although hospitals have also come under fire for cost-shifting financial risk to commercially insured patients. Meanwhile, many have come under financial pressure from patients who cannot cover their out-of-pocket costs.
Former Kentucky Gov. Steve Beshear was among the biggest proponents of the ACA, making Kentucky one of the few Southern states to expand Medicaid and operate its own health insurance exchange. But his replacement, Gov. Matt Bevin, campaigned against the ACA. He has already dismantled KYNect, the state's insurance exchange, and has designs on rolling back the Medicaid expansion.
Bevin is pushing for strings to be attached Medicaid coverage, including paying premiums and having to work, according to WFPL Radio. Those changes could force many Kentuckians to drop out of the program.
“They create more uncompensated care because they create more uninsured people--they can’t access coverage because the premium cost is a barrier,” Deborah Bachrach, a partner with Manatt Health, told WFPL.