Rural hospitals are hurting in states that chose not to embracethe Affordable Care Act’s expansion of Medicaid.

|

The expansion, which was originally crafted to be mandatory butwas rendered optional by a Supreme Court decision, was fundedentirely by the federal government for the first several years andwill be 90 percent federally-funded in the long-run. The expansionenables states to raise the eligibility for Medicaid to allhouseholds below 133 percent of the federal poverty level.

|

A study published this week in Health Affairs found that Medicaid expansion had a muchgreater impact on the bottom lines of rural hospitals’ than thoseof urban hospitals.

|

In states that chose to expand Medicaid, rural hospitals gainedsignificant revenue, while urban hospitals did not appear to begreatly affected.

|

Whence comes the disparity? Rural areas are poorer, explain theUniversity of North Carolina researchers who authored thestudy.

|

While plenty of American poverty is urban, big metro areas arebetter off in the grand scheme of things than rural areas. A largerpercentage of hospital patients in urban areas are well-to-do andhave good insurance.

|

Research has shown that uncompensated hospital care has declinedas a result of the ACA, the most significant part of which has beenthe Medicaid expansion. A study last year found that in 2014, thefirst full year of the ACA implementation, hospitals experienced a$7.4 billion drop in uncompensated care.

|

However, in states that did not expand, hospitals did notbenefit nearly as much.

|

“If you’re [a hospital] in a state that did expand Medicaid,obviously you’re going to be experiencing lower amounts ofuninsured. Your bad debts and charity care have gone down,” BrockSlabach, senior vice president at the National Rural HealthAssociation, told Kaiser Health News.

|

Nearly three years after the implementation of the ACA, sevenRepublican-run states that initially resisted Medicaid expansionhave reversed course. In Louisiana, that happened after a Democrattook over as governor last year, but in five other states it wasRepublican governors and legislatures that changed their mind onthe issue. In Alaska, the effort was led by an independentgovernor.

Complete your profile to continue reading and get FREE access to BenefitsPRO, part of your ALM digital membership.

  • Critical BenefitsPRO information including cutting edge post-reform success strategies, access to educational webcasts and videos, resources from industry leaders, and informative Newsletters.
  • Exclusive discounts on ALM, BenefitsPRO magazine and BenefitsPRO.com events
  • Access to other award-winning ALM websites including ThinkAdvisor.com and Law.com
NOT FOR REPRINT

© 2024 ALM Global, LLC, All Rights Reserved. Request academic re-use from www.copyright.com. All other uses, submit a request to [email protected]. For more information visit Asset & Logo Licensing.