A number of publicly traded hospital operators in Tennessee, which operate in other states, are bullish on Obamacare, particularly about the big decline in the number of uninsured people showing up in emergency rooms after Medicaid expansion. It's happening to a certain extent in states that didn't expand as well, because of all the new Medicaid enrollments that came from people who didn't know they were eligible until they showed up to get insured.
Community Health Systems CFO Larry Cash told investors and analysts during the company’s first-quarter earnings call Wednesday that the ACA should decrease self-pay admissions from about 8 percent to about 4 percent over a three-year period. The company has seen some early moderate impacts, especially in Medicaid expansion states where self-pay admissions have already begun to drop, Cash said.Another hospital group, HCA, said that in the four states in which it operates that have expanded Medicaid, they'd seen a 29 percent decline in admissions of people without insurance, but a 5.9 increase in the non-expansion states.
"We believe we have recognized, although on a roughly calculated basis, at least $10 million from the 'woodwork effect' [in which people currently eligible for Medicaid but who had yet to sign up will now do so because of the ACA] and the Affordable Care Act for additional Medicaid business," Cash said. […]
"So far and as expected, the new health care law has been a net positive for LifePoint with respect to Medicaid expansion," CEO Bill Carpenter said during the call. "In the seven states where we operate that have expanded coverage, we saw increasing Medicaid and decreasing self-pay volumes. Increases in Medicaid membership and health insurance exchange participation contributed measurably to our results in the quarter. While we don’t expect additional states to expand coverage in 2014, we’re optimistic that more conversions will occur over time."
A 29 percent decrease is pretty huge, meaning big savings for the hospitals, but also big savings for the local and state governments that won't have to figure out how to help the hospitals pay for all that uncompensated care. That's the big argument hospitals in all the states that didn't expand have been trying to make—Medicaid expansion makes sense not just because it means saving lives, because it also saves money.