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In states where governors rejected the Medicaid expansion, how are hospitals  financing the care of those who can't afford Obamacare premiums?

  • How are hospitals in states where governors rejected the Medicaid expansion financing the care of those who can't afford Obamacare premiums, especially since hospitals are legally required to treat everyone, including illegal workers and the American citizens who don't pay into Obamacare?

  • Answer:

    The same way they always have. The hospitals pay. They write off the full price they charged, but only actually lose the small percentage of that the treatment actually cost them. The tax breaks are likely larger than what they spend on indigent care. The thing to keep in mind about Medicaid expansion is it becomes a partially funded mandate in 2017, and an unfunded mandate in 2024. Florida, for example, would have to increase it's total budget by 7% in 2017, and an additional 64% in 2024 (using current budget and Medicaid costs) in 2024 if they expanded. Which is why Florida hasn't done it. It's an outrageously expensive program, and it won't be at all surprising if it winds up bankrupting more than one state.

Matt Wasserman at Quora Visit the source

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No mystery here - hospitals will continue to do what they have always done relative to negative margin. They will "cost shift" the expense to the one category of care that generates a positive margin. Here's how that chart looks: Medicare, Medicaid and uninsured categories are negative margin to a hospital. When you increase any of those categories - you have to raise the rate of what you charge the one paying category - commercial insurance.

Dan Munro

They are not treating the uninsured. They are doing the minimum required to stabilize the patient in the ER, which is the extent of their legal requirement, and summarily discharging the patient. The term they use is Fast Track. A broken arm is a good example. In the old days, the ER put a cast on it. Now they put a splint on it, hand him a list of three orthopedists, and shove him out the door. Needless to say, the three orthopedists will not even talk to an uninsured patient.This is not hypothetical, it is happening a dozen times a day at Halifax Hospital in Daytona Beach FL.Their ER will not admit non-emergency cases.

Robert Wagner

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