Report shows Medicaid expansion helping reduce uncompensated care

The number of uninsured or self-pay hospital admissions and emergency department visits has fallen substantially in states that chose to expand Medicaid, which has helped hospitals' bottom lines - according to a new government report.

The U.S. Department of Health and Human Services said hospitals' uncompensated care is estimated to be $7.4 billion or 21 percent lower last year 4 than it would have been had Medicaid coverage not been expanded under the Affordable Care Act.

Uncompensated care is the unreimbursed cost of care hospitals provide to people who are uninsured or underinsured. Hospitals provided more than $50 billion in uncompensated care in 2013, according to HHS.

The report found that Medicaid expansion states saw significantly greater reductions in their uncompensated care costs in 2014, $5 billion in expansion states compared with $2.4 billion in non-expansion states.

HHS reported that if non-expansion states had proportionately as large of increases in Medicaid coverage as expansion states, their uncompensated care costs would have declined by an additional $1.4 billion.

Expansion states also saw a larger reduction in bad debt and charity care than non-expansion states - $3.9 billion and $1.1 billion compared with $1.6 billion and $800 million, respectively, according to HHS data.

Iowa is one of the 28 states that expanded Medicaid. The Iowa Health and Wellness Plan, which started in January 2014, has more than 115,000 enrolled, including about 3,600 enrolled in Johnson County and 9,000 enrolled in Linn County, according to the state's Department of Human Services.

Impact in C.R.

And hospitals in Cedar Rapids are beginning to see the expansion's benefits.

Mercy Medical Center in Cedar Rapids told The Gazette in February that it saw a 4 percent to 5 percent increase in Medicaid patients in 2014 along with a 1 percent decrease in the number of uninsured patients it cares for.

Overall, the hospital has seen a drop in the amount of uncompensated care it provides, Mercy officials said, but the trend of more patients having plans with large out-of-pocket maximums means the hospital still is awarding a quite a bit of charitable care.

Meanwhile, UnityPoint Health-St. Luke's Hospital said there has been a 50 percent decrease of in the number of self-pay patients treated between 2013 and 2014. The hospital also saw a 30 percent increase in individuals covered by Medicaid.