A Baton Rouge, La., hospital is closing the only emergency room on the city's impoverished north side, a real-world ripple effect of the ideological clash over President Barack Obama's health care law.
The shutdown on April 1 serves as an early warning for hospitals in states like Louisiana, where Republican Gov. Bobby Jindal turned down federal money to expand the Medicaid program for the poor. Charity hospitals will lose billions of federal aid beginning late next year, a cut that was supposed to be offset as more residents were covered by Medicaid.
In Louisiana, Baton Rouge General's Mid City hospital was already caught in that vise. It was flooded with the uninsured after a nearby charity hospital was closed. Louisiana provided a one-time injection of funds last year from the federal aid program that's about to be cut. With that money gone, the hospital is closing the emergency room.
Let's review the way Medicaid expansion was supposed to work.
First, Medicaid reduced the amount of money hospitals will be reimbursed for providing health care to people whose income falls below a certain level.
At the same time, by expanding Medicaid eligibility, more people will be insured, having two effects. (1) Insurance payments will offset the loss of payments to the hospital; and (2) because people now have medical insurance, they will establish a relationship with a physician thereby staying healthier and avoiding emergency room visits because untreated illness can be caught early.
In (Republican-controlled) states where Medicaid expansion was not enacted, hospitals are feeling a huge pinch and, very likely, this closing in Baton Rouge is only the beginning of a nationwide trend. In fact, here in Virginia, Lee Regional Medical Center in Pennington Gap -- the only medical center serving a mountainous region with a mostly poor, elderly population -- closed a year ago for the same reason.
A study by the Colorado Hospital Association found that hospitals in states that accepted Medicaid expansion are in much better financial shape than hospitals in states that did not accept Medicaid expansion.
After gathering data from 465 hospitals in 30 states -- 15 that expanded Medicaid and 15 that did not -- the report concluded that in states that chose to participate in Medicaid expansion, the average charity care cost per hospital decreased from $2.8 million to $1.9 million.
In non-expansion states, hospitals witnessed an increase in charity care spending, from $3.8 million to $4.2 million, with the proportion of Medicaid and self-paying patients remaining unchanged.
Of course, these ARE Republicans we're talking about -- don't confuse them with facts. When I presented the findings of this study to my Republican representative in the Virginia House of Delegates,
she waved off the study as biased.
Oh, and did I mention that Piyush Jindal inherited an $800 million budget surplus from his predecessor, Gov. Kathleen Blanco (D) -- and is now facing a $1.6 BILLION deficit?
Piyush Jindal -- clearly GOP Presidential material.