Red States Pressured To Expand Medicaid As Care Contrasts Emerge

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Pressure is building on states to go along with the expansion of Medicaid benefits under the Affordable Care Act as new studies and financial reports from health care companies point out stark differences between states treating more poor Americans and those that aren’t.

One of the nation’s largest hospital operators, Tenet Healthcare THC -0.25% (THC), last week opened a window into the differences for patients and hospital financial coffers between those states with Medicaid dollars and those without.

“In our five states that expanded Medicaid in 2014, we benefited from a significant migration of patients from uninsured into Medicaid with a 54% decline in uninsured admissions and a 27% decline in uninsured outpatient visits,” Tenet chief executive Trevor Fetter said during the company’s second-quarter earnings call last week.

Tenet saw across-the-board increases in “admissions, outpatient visits, surgeries and emergency department visits,” Fetter said.

The federal government traditionally picks up a little more than half of the cost of Medicaid. But funding under the health law is unlike past efforts to expand Medicaid in that the federal government will pick up the full tab this year as well as 2015 and 2016. The state gradually has to pick up some costs in 2017, but by 2020, the federal government is still picking up 90 percent or more of the Medicaid tab

A report last week from The Robert Wood Johnson Foundation-funded Urban Institute said states that haven’t expanded will “miss out” on more than $420 billion in federal dollars between now and 2022. In addition, the states that don’t expand are losing out on increased employment in the health care industry from newly insured patients who have help paying for services.

“States are literally leaving billions of dollars on the table that would support their hospitals and stimulate the rest of their economies,” the Robert Wood Johnson Foundation’s Kathy Hempstead said in a report accompanying the Urban Institute report.

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