The Missouri General Assembly has declined to expand the Medicaid roles until state Senate and House review panels can issue a report. Zechman says he doesn't see that happening for at least six to nine months. As a result, hospitals in Missouri are bracing for a triple-whammy:
"We are going to get that cut anyway even though Medicaid expansion is not happening in Missouri," Zechman says. "The disproportionate share cut was made and it was anticipated that the hospitals would recoup that money back through expanded Medicaid and the insurance exchanges. The exchanges might get a little back, but we aren't going to get anything from the Medicaid expansion."
It's not just the hospitals and the vulnerable who will be hurt.
A University of Missouri analysis commissioned by the Missouri Hospital Association estimates that the Show Me State will be shown that it could lose more than 9,000 jobs, $1.9 billion in reduced capital investment, or $1.1 billion in cost shifting to private plans with the decision not to expand Medicaid.