Last week we got a hint from some hospital companies operating in multiple states that they were seeing something very real happen after the first enrollment period for Obamacare—fewer uninsured people seeking care. The Washington Post's Jason Millman follows up on that report, reviewing the last few weeks of earnings calls for publicly traded hospitals and comes to a clear conclusion: "They're reporting a blue state-red state divide in the kinds of patients they're seeing."
The Hospital Corporation of America, which has facilities in 20 states, reported a big gap in Medicaid and uninsured admissions between expansion and non-expansion states. In the four states it operates where Medicaid expanded under the ACA, the company saw a 22.3 percent growth in Medicaid admissions, compared to a 1.3 percent decline in non-expansion states. The company also had a 29 percent decline in uninsured admissions in the expansion states, while non-expansion states experienced 5.9 percent growth in uninsured admissions, chief financial officer William Rutherford said.That's good news for these hospitals' bottom line, and why so many hospitals have lobbied state governments hard for Medicaid expansion—Medicaid reimbursements are certainly preferable to no reimbursements at all. That 30 percent drop in uninsured patients is pretty huge. That's not just saving the hospitals money, it's saving the states money. The states end up paying for a lot of uncompensated care hospitals provide, so reducing the numbers of those uninsured patients makes a lot of fiscal sense.
Community Health Systems, with facilities in 29 states, also noticed an expansion gap. In expansion states it serves, CHS said it saw self-pay admissions drop 28 percent while Medicaid admissions increased by 4 percent. Self-pay emergency room visits decreased 16 percent in expansion states, but they increased in non-expansion states, the company said in its earnings call last week.
Tenet Healthcare reported last week that it had a 17 percent increase in Medicaid inpatient visits while uninsured visits decreased 33 percent in the four expansion states where it operates. In non-expansion states, Medicaid admissions dropped 1 percent as uninsured care rose 2 percent. Tenet also said it's seeing that emergency room visits are continuing to rise.
But fiscal sense—and the moral imperative of saving tens of thousands of lives—means bupkis to Republicans who hate Obamacare.