Uncompensated care costs could soar despite reform

The combination of individual states rejecting Medicaid expansion as part of the Affordable Care Act and cuts in disproportionate share hospital (DSH) payments could cause uncompensated care tabs to balloon in the coming years, according to a new report from the National Association of Public Hospitals and Health Systems (NAPH).

The NAPH data concluded that total uncompensated care costs could rise $53.3 billion by 2019. That is based on an assessment of states rejecting Medicaid funding while DSH payments are cut by as much as $14.1 billion.

The association made its calculations using data from the Congressional Budget Office, which estimates as many as 10 million fewer Americans will have healthcare coverage now that states can opt out of expanding Medicaid, The Washington Post reported.

"Congress certainly didn't foresee this level of uninsured and uncompensated care when it enacted the ACA," NAPH CEO Bruce Siegel, M.D., said last week in a statement. "In this light, the deep cuts to disproportionate share hospital payments over the same period are simply untenable and will prove devastating to society's most vulnerable and to the providers who care for them," he said.

To date, six states have opted out of expanding Medicaid, according to the Post, while five others are leaning toward forgoing expansion. However, most states are still undecided on the measure.

Facing an increasing uncompensated care burden, NAPH is advocating the repeal of DSH cuts.

For more information:
- check out the Washington Post article
- here's the NAPH statement (.pdf) and report summary