Public hospitals: Not expanding Medicaid will be a 'disaster'

The decision to keep Medicaid rolls as-is and forgo expansion as allowed under health reform would be devastating for safety-net hospitals and patients, HealthLeaders Media reported.

That's because between 4 million and 13.8 million people who would have been eligible for Medicaid live in states that have chosen to opt out of expanding, Bruce Siegel, M.D., President and CEO of the National Association of Public Hospitals and Health Systems, said in a statement earlier this month.

Making Medicaid expansion voluntary while simultaneously cutting disproportionate hospital share payments "will be a disaster," Siegel told HealthLeaders yesterday. "You can have a safety net for public hospitals or you can have Medicaid coverage. But what's happening is that we are walking away from both," he said.

According to Siegel, in states that choose to opt-out of Medicaid expansion, more than half of the charity care burden will fall on the shoulders of safety-net hospitals. In fact, one NAPH member said not expanding Medicaid, coupled with DSH cuts, will force the hospital to close.

Safety nets in Florida, Texas and Louisiana, in particular, will face tough challenges as they already treat large numbers of underserved patients, HealthLeaders noted.

In addition to enabling hospitals to continue serving uninsured and low-income patients, expanding coverage leads to greater access and higher-quality local healthcare services for the insured population, as well, Siegel noted in the statement. "Simply put, coverage matters," he said.

With that in mind, some hospitals have already started calling on states to expand Medicaid programs, ramping up lobbying efforts to their states' Republican lawmakers.

However, hospitals in states that plan to expand Medicaid coverage still will have their own financial burdens from the larger volume of Medicaid patients they expect to treat.

For more:
- read the HealthLeaders article
- here's the NAPH statement (.pdf)