"The question is not really whether Medicaid will put hospital revenue in the black, it is more a question of how deep in the red hospitals can go," said David Dillon, VP of media relations at the Missouri Hospital Association. "Without new Medicaid coverage and revenue… hospitals will not only experience the federal cuts but continue to shoulder high uncompensated care costs. In 2012, the most recent year of full data, Missouri's hospitals provided $1.17 billion in uncompensated care."
At the heart of the federal Medicaid expansion push is a guarantee from Washington to pick up the entire tab through 2016. In subsequent years through 2020, the federal reimbursement rate to the states will be tapered to 90 percent.
Pre-expansion Medicaid programs have federal reimbursement rates ranging from 50 percent to 74 percent.
The MHA has established a coalition with business leaders to help break Missouri's Medicaid expansion logjam. "The ACA is the law of the land. In Missouri, the hospital community has teamed up with the Missouri Chamber of Commerce and Industry to move the discussion forward," Dillon said.
"Businesses understand that without a Medicaid reform and expansion law, they will be exposed to significant cost shifting to support uncompensated care. For Missouri's business community, this has been a kitchen table issue, not a foray into the culture wars."