Medicaid opt-out could cost hospitals $400M

Missouri's hospitals claim they will lose hundreds of millions of dollars in revenue each year if the state does not participate in Medicaid expansion as part of the Patient Protection and Affordable Care Act, reported the St. Louis Post-Dispatch.

It is calculated that the hospitals will lose up to $400 million in disproportionate share hospital (DSH) payments, according to the article. DSH payments are earmarked to hospitals that treat a higher-than-average number of uninsured patients, and are slated to be eliminated in 2014 in lieu of a dramatic expansion of Medicaid.

"If you don't expand Medicaid and you eliminate the DSH funding, you have the ability to significantly impact hospitals' financials," Missouri Hospital Association spokesman Dave Dillon told the Post-Dispatch. "It's extremely problematic."

As a result, lawmakers in Missouri are expected to come under considerable pressure from the Show Me State's hospital lobby, the newspaper reported.

Meanwhile, a Congressional Budget Office report released late last month projects that some states will not participate in the Medicaid expansion, and many will put it off beyond 2014. However, it did note that those residents of states who do not wind up enrolled in Medicaid because their states do not participate would still be able to purchase heavily subsidized coverage through the health insurance exchanges.

For more:
- read the Post-Dispatch article
- here's the CBO report (.pdf)