Hospitals in Medicaid Expansion States Have Lower Charity Care Rate, According to Study

Hospitals located in states that have expanded Medicaid are faring better overall than their counterparts in non-Medicaid expansion states, according to a new report by the Kaiser Family Foundation. The report studied Ascension, the nation's largest not-for-profit health system, to determine the effects of the ACA on its hospitals. Overall, hospitals in expansion states saw increased Medicaid discharges, increased Medicaid revenue, and decreased costs for the lowest-income individuals. Most notably, hospitals in expansion states saw a reduction in charity care costs of 40.1% compared to 6.2% in non-expansion states.

Arkansas: State Continues to Study Alternatives to the Private Option

With the federal waiver for the State’s Medicaid expansion (the “Private Option”) set to expire at the end of 2016, Arkansas lawmakers continue to evaluate various options, including applying for a 1332 waiver to develop an alternative coverage model for the expansion population. A report released by the Arkansas Health Insurance Board outlines two options that the authors describe as “departures from the way CMS has thus far typically described what a 1332 Waiver program might look like” and “would involve negotiating a novel program approach with CMS and the IRS.” Meanwhile, Governor Asa Hutchinson (R) attended the kick-off of his Advisory Council on Medicaid Reform, and as reported by the Arkansas Democrat-Gazette, instructed the Council to focus on "expanding the range of options," which may include giving up enhanced federal funding for Medicaid expansion. The Governor said, "It might be a good solution for Arkansas, and we don't know exactly what's going to happen totally at the federal level down the road."

California: Medicaid Expansion Correlates with Decrease in Uninsured Emergency Department Visits

The California Office of Statewide Health Planning and Development released new data highlighting the correlation between the State's Medi-Cal expansion and a decrease in Emergency Department (ED) visits by uninsured patients, from 450,000 visits in the third quarter of 2013 to 278,000 in the fourth quarter of 2014. In addition, the data show that ED visits for Medi-Cal beneficiaries increased approximately 50%, from 800,000 visits in the first quarter of 2013 to 1.16 million in the fourth quarter of 2014. The State expanded Medi-Cal in January 2014, which increased enrollment from 8.6 million beneficiaries in the fall of 2013 to approximately 11.3 million beneficiaries by the end of 2014.

Florida: Battle over Uncompensated Care Funding and Medicaid Expansion Reaches Breaking Point

The battle over the continuation of Florida’s uncompensated care funding pool and Medicaid expansion came to a head when the House adjourned its legislative session three days early, citing irrevocable policy differences with the Senate and leaving the State FY 2015-2016 budget unresolved. Governor Rick Scott (R) responded swiftlyfiling a lawsuit against the Obama administration for linking the renewal of the funding pool to the State’s Medicaid expansion status and stating that his office would begin working with the House and Senate to build a budget before the June 30 deadline. The Governors of Kansas and Texas have voiced their intent to file amicus briefs supporting Florida, reports the Orlando Sentinel. Governor Scott specified that conversations about Medicaid expansion or the Low-Income Pool (LIP) funding would remain separate from budget negotiations and that his newly created Commission on Healthcare and Hospital Funding would soon launch an investigation of “the revenues of Florida hospitals, insurance and healthcare providers and how any taxpayer money contributes to the profits or losses of these institutions in Florida.” Florida Supreme Court ruled at the end of the week that the House violated State constitution by ending the session early, but that it was too late to require lawmakers to return for the end of the session.

Montana: Governor Signs Act to Expand Medicaid

Governor Steve Bullock (D) signed Senate Bill 405, the Montana Health and Economic Livelihood Partnership Act (HELP Act), into law, expanding Medicaid to cover an estimated 70,000 new adults. The legislation authorizes the State Department of Public Health and Human Services to seek a waiver from CMS to implement the expansion through a Third Party Administrator. For more information, click here to read Manatt's analysis of the expansion bill.

Pennsylvania: Medicaid Expansion Transition Begins

The Pennsylvania Department of Human Services began transitioning nearly 100,000 individuals from Healthy PA, the Medicaid expansion program created by former Governor Tom Corbett (R), into HealthChoices, a traditional Medicaid expansion enacted by current Governor Tom Wolf (D). HealthChoices is administered through the State’s system of managed care plans with a single benefit package that includes a number of benefits that were not offered in all of the three Healthy PA plans, including dental treatment, transportation to medical appointments, dialysis, and some behavioral health benefits. Individuals will be transitioned from Healthy PA plans into HealthChoices in waves, with all transitions complete by September 30.