West Plains Daily Quill

By: Abby Hess

The Georgetown University recent study on the benefits and disadvantages of Medicaid expansion is discussed thoroughly, providing direct quotes and statements from the co-authors, Jack Hoadley and Adam Searing, and other contributors.

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A recently-released study conducted by Georgetown University highlights the impact of Medicaid expansion – or lack thereof – on hospitals that provide a significant level of care to low-income and uninsured patients. Representatives of three area hospitals discussed the study with the Quill, affirming its findings that Missouri’s non-expansion status is leaving hospitals in difficult financial straits.

The study, conducted by Adam Searing with Georgetown University Center for Children and Families and Jack Hoadley with the university’s Health Policy Institute, was released earlier this month, and focused on looking beyond reducing the number of patient cases without compensation, or payment, to the financial impact expansion has on safety net hospitals.

However, they noted, the same observations were not made in non-expansion states where financial pressures are still an obstacle to be overcome. “Medicaid expansion has not solved all problems for these providers, as they continue to have difficulty in finding specialists who will accept Medicaid,” they report.

Searing and Hodley noticed during the course of their interviews that safety net providers are seeing fewer uninsured patients in states that have expanded Medicaid coverage, with officials in different medical facilities reporting drops of 15 to 34 percent in total numbers of patients without insurance seeking care. Conversely, an official in a non-expansion state said the number of uninsured patients had risen by 11 percent.

Searing and Hoadley noted that hospitals serving a significant number low-income and vulnerable patients are seeing more financial security in expansion states, while hospitals in states like Missouri still struggle.

“For example,” they report, “one federally-qualified health center went from a $2.5 million end-of-year loss prior to expansion to a $2.5 million surplus the year after,” a $5 million reversal in just one year.

Searing and Hoadley also reported that access to specialty care is improved in states that have expanded coverage, but room for further improvement exists. Officials in expansion states report that they are able to address this need for improvement by collaborating, hiring new staff, and creating new initiatives aimed at increasing access to specialists.

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