Hospitals in two mostly rural states that have yet to expand Medicaid coverage may now have to eliminate jobs and services to cut costs.
The Franklin Community Health Network in Maine has cut about two dozen jobs in recent weeks in order to address the issues, part of a broader plan to eliminate 40 positions, according to the Portland Press Herald.
An increase in bad debt is forcing the Wyoming Medical Center, one of the state's largest acute care providers, to consider changing its delivery of services to cut costs. The organization will likely see its bad debt go up from $5 million to $26.5 million, according to the Wyoming Business Report.
Vickie Diamond, the Wyoming Medical Center president and chief executive officer, is also seeking a "loose affiliation of hospitals" in the state that might give the organizations better bargaining power with insurers, helping to cut costs further.
Both states have Republican governors that have objected to Medicaid expansion, although lawmakers in both states have introduced bills to try and obtain the additional funding under the Affordable Care Act.
Altogether, 18 states have yet to expand Medicaid, most in the South or rural West. That's despite the fact that a variety of studies have concluded that such a decision deprives hospitals of billions of dollars of revenue to take care of patients they will have to care for anyway. In states such as Georgia, many rural hospitals have been greatly challenged to keep their doors open in the wake of not expanding Medicaid.
Hospitals in states that expanded Medicaid avoided $7.4 billion in uncompensated care costs in 2014, according to the U.S. Department of Health and Human Services.