Public hospitals in every state that refused Obamacare's Medicaid expansion have suffered, and more than a few
have been forced to close. In the state with the highest uninsured rate in the country—Texas—hospitals are sounding an alarm, and are
desperately trying to overcome Republican opposition to Obamacare in the state.
Baylor University Medical Center lost $172.8 million on uncompensated care last year.
Texas Health Presbyterian Hospital Dallas reported uncompensated care of $86.5 million. Methodist Dallas Medical Center reported $154.7 million.
And Parkland Health and Hospital System reported $1.488 billion of uncompensated care. […]
The Texas Hospital Association is trying to remedy that, at least in part. It wants to coax Governor-elect Greg Abbott and the Legislature to use federal funds available through the Affordable Care Act to expand Medicaid with a private insurance model.
Those are the amounts lost by hospitals based on what they normally charge privately insured patients. Adjusted for Medicaid and Medicare reimbursements, it's not as drastic, but still unsustainable. Parkland's loss from uncompensated care last year was $359 million. One hospital system in one year.
More than 1 million Texans fall into the Medicaid gap. The approach the Association is pushing is modeled after what Gov. Mike Pence (R) is trying to do in Indiana. That "private option" Medicaid plan would feature private plans with high deductibles and require participants to put some income into health savings accounts. That approach seems to have doomed Indiana's plan with the federal government, which has to agree to any state's approach to release the funds. That provision seems to be a bit of a hold-up for the feds, but negotiations continue.
Indiana might not be the best model for Texas hospitals to point to, but it's critical that they continue the fight. The only hope for the million Texans who have fallen into the coverage gap is powerful economic and political stakeholders like hospitals taking on the charge. It's a slim hope in a state like Texas, but it's all they've got.