Virginia, one of the most populous states that has not expanded Medicaid eligibility under the Affordable Care Act (AHA), is investigating other ways to obtain and use federal funding.
The state has convened a workgroup that will explore "provider assessments," essentially a twist on hospital bed taxes, WVTF radio reported. The revenues could be used to obtain additional matching Medicaid payments from the federal government.
Even though it is an expansion state, California has used the bed tax to successfully draw down hundreds of millions of dollars in matching funds.
Twenty states have yet to expand Medicaid under the ACA. Although there has been a significant drop in the uncompensated care hospitals have reported since the law passed, the reduction has disproportionately occurred in states that have expanded Medicaid eligibility.
Alternatively, the fees could also be used to fund increases in payments to physicians and other providers participating in the Medicaid program.
"It's been a long time since we've increased fees to doctors. It's been a long time since we've increased certain inpatient rates," Manatt Healthcare Analyst Deborah Bachrach told WVTF. "The non-federal share could be used to increase rates of payments to providers."
Gov. Terry McAuliffe, a Democrat, recently pledged to push for expansion, suggesting that opposition in the Republican-controlled Legislature has softened, according to the Associated Press. But Republican lawmakers say that's not the case. McAuliffe could take bolder action, as did Alaska Gov. Bill Walker, an independent who recently decided to expand the program on his own executive authority.