Missouri Hospitals: Without Medicaid Expansion, Uncompensated Care Will Explode

The Missouri Hospital Association has cautioned that if the state does not participate in the Medicaid expansion that is part of the Affordable Care Act, the levels of uncompensated care provided by hospitals will nearly triple by the end of the decade.

MHA called the potential rise in uncompensated care a “hidden” tax expected to be borne by many of the Show Me State's 6 million residents through cost-shifting to those with insurance.

“Few Missourians realize the high cost they pay for caring for the state’s uninsured and underinsured,” said MHA President Herb B. Kuhn. “Medicaid reform provides an opportunity to reduce the costshift.”

Under the ACA, states that agree to expand Medicaid eligibility to 138% of the federal poverty level would receive full federal funding for the expansion for three years. The funding would drop to 90% in the years after that.

However, resistance to the ACA, the cornerstone legislation to date of the Obama Administration, has been particularly fierce in states with conservative statehouses. Although Missouri Gov. Jay Nixon is a Democrat, both branches of the Legislature are controlled by Republicans – the vast majority of whom are opposed to Medicaid expansion. However, Nixon has indicated in recent days some form of compromise could be reached.

A new report the MHA released on Monday predicted the levels of uncompensated care would rise to as high as $3.5 billion a year by 2019. It was $1.3 billion in 2011, up from $690 million in 2002. The report suggested that businesses providing coverage to its workers would pay for most of that cost. It noted that although it was “no fan” of the ACA, the state's Chamber of Commerce and Industry supports Medicaid expansion.

According to data from the Kaiser Family Foundation, Medicaid expansion under the ACA would add about 800,000 Missourians to the roles. The state currently has an enrollment of just under 1 million.

“The last thing Missouri employers need right now is another tax … especially one that could be assignificant as this hidden tax would be,” asked Dan Mehan, president of the Missouri Chamber of Commerce and Industry. “Instead, we urge lawmakers to protect Missouri employers by passing responsible Medicaid expansion legislation and bring Missouri’s hard-earned federal tax dollars back to our state.”