The Effect of Medicaid Expansion on Charity Care Costs

Let me just be honest about my biases.  I think it is absolutely shameful that 19 states, including Florida, have refused to participate in Medicaid expansion.  It’s free money, for Christ’s sake, you idiots! But I digress and I am supposed to be a scholar and speak in cold unemotional logic.  So let me restate my opinion in the language of a scholar:  Ahem . . . .  It’s free money, for Christ’s sake, you idiots!  Anyway, we have previously blogged about the early impact of the affordable care act on hospital charity care costs.  A more recent report by the Kaiser Family Foundation confirms the early trend:

Looking at particular cost items, charity care costs decreased 40.1 percent among hospitals in Medicaid expansion states compared to 6.2 percent in non-expansion states. However, another component of cost of care to the poor, Medicaid shortfalls – the difference between what Medicaid pays and the costs of treating Medicaid patients – increased 31.9 percent between 2013 and 2014. Shortfalls increased for hospitals in expansion states but were more than offset by increases in Medicaid revenue. Shortfalls increased more among hospitals in non-expansion states than expansion states and were not offset by increases in Medicaid revenue, possibly due to state cuts in provider reimbursement. Combining the decrease in charity care costs with the increase in Medicaid shortfalls, the net cost of caring for low income patients decreased among hospitals in expansion states, while these costs increased among hospitals in non-expansion states.

So let me get this straight.  The feds, using our tax dollars, will pay 90% of the costs of Medicaid expansion — 100% until 2020.  Charitable costs will likely increase without medicaid expansion anyway, meaning we will pay for indigent care one way or the other.  But the nefarious nineteen (as I will call them from now on) don’t want any of “Obama’s stinking money.”  Yeah, that’ll teach us, alright!  We should remind the knuckleheads that Obamacare was based entirely on Romneycare!

dkj