Of all the healthcare providers most severely impacted by the U.S. Supreme Court's Patient Protection and Affordable Care Act ruling last month, public safety net hospitals, of which there are 1,000 in this country, are at the top of the list.
These are the hospitals caring millions of the underserved. They are the sickest and most difficult patients. The biggest hospitals often can be found in the poorest parts of town. Think of troubled Parkland Health & Hospital System in Dallas, or Jackson Memorial Health System in Miami.
Now these hospitals are threatened with a double whammy. First, if they exist in one of the 30 states now threatening to refuse to expand their Medicaid eligibility rules to 138% of the federal poverty level, they'll continue to provide uncompensated care for many of their sickest patients.