Blog | Wednesday, December 18, 2013

Broken dishes


Here’s an idea that seems unfair:

Hospitals, long searching for ways to minimize their streams of uninsured patients (written off as “charity” or “uncompensated” care), signed on to the Affordable Care Act (“Obamacare”) through their trade associations.

They stood to solve one of their longstanding problems by cooperating with Congress and the Administration to help Americans.

Now, in states not accepting Medicaid expansion (e.g. Georgia, Oklahoma, Texas, etc.), those hospitals are feeling the pinch twice.

Obamacare is in part financed by funds earmarked for hospitals providing a “Disproportionate Share” (i.e. “DSH“) of unfunded care.

Now hospitals in states that aren’t expanding Medicaid not only won’t get payments from newly enrolled Medicaid-eligibles, they’ll be losing their “DSH” payments.

Double whammy.

Here’s the thing, though: Stubborn governors and legislators who will not accept the 100% federal financing of Medicaid expansion will feel the bite. Eventually.

Hospitals will close. Citizens will be angered. Employees will lose jobs.

Those last two in any order.

This post by John H. Schumann, MD, FACP, originally appeared at GlassHospital. Dr. Schumann is a general internist. His blog, GlassHospital, seeks to bring transparency to medical practice and to improve the patient experience.