The Consequences Of Not Expanding Medicaid: A Significant Increase In Hospital Closures

Stat: In States That Didn't Expand Medicaid, Hospital Closures Have Spiked
In recent years Obamacare’s Medicaid expansion has created a financial fault line in American health care. Hospitals in states that enacted the expansion got a wave of newly insured patients, while those in states that rejected it were left with large numbers of uninsured individuals. A new study released Monday reports a crucial consequence of that divide: Nonexpansion states have suffered a significant increase in hospital closures. States that expanded benefits, on the other hand, saw their rate of closures decline. (Ross,1/8)

NPR: Hospitals In States With Medicaid Expansion Are Surviving
Hospitals in states that expanded Medicaid were about 6 times less likely to close than hospitals in non-expansion states, according to a study by researchers at the University of Colorado Anschutz Medical Campus. The study was published Monday in the January edition of the journal Health Affairs. Colorado was one of 32 states to expand Medicaid under the Affordable Care Act. That cut the state's uninsured rate in half. The biggest group that got coverage was childless adults. (Daley, 1/8)

Modern Healthcare: Changes To Medicaid Could Accelerate Hospital Closures 
Researchers examined CMS data on hospital closures and their financial performance between 2008 and 2016. They found hospital closure rates were the same from 2010 to 2012 among states that eventually expanded Medicaid versus states that opted not to expand. Closure rates between expansion and non-expansion states began to diverge in 2013, a year after the U.S. Supreme Court ruled states had the option to expand Medicaid to cover all adults earning up to 138% of the federal poverty level. The hospital closure rate for non-expansion states doubled from 0.45 per 100 hospitals in 2012 to 0.90 in 2013, the researchers found. (Johnson, 1/8)

Denver Post: A CU Professor Explains How Obamacare Prevented Hospitals From Closing 
“We estimated,” said Richard Lindrooth, a professor at the Colorado School of Public Health who is a co-author of the new study, “that about half the closures that occurred in states that did not expand Medicaid could have been prevented if they did expand Medicaid.” (Ingold, 1/8)

In other hospital news —

Kaiser Health News: Despite Prod By ACA, Tax-Exempt Hospitals Slow To Expand Community Benefits
The federal health law’s efforts to get nonprofit hospitals to provide more community-wide benefits in exchange for their lucrative tax status has gotten off to a slow start, new research suggests. And some experts predict that a recent repeal of a key provision of the law could further strain the effort. The increased emphasis on community-wide benefits was mandated by the Affordable Care Act. The health law required hospitals that meet federal tax standards to be nonprofits to perform a community health needs assessment (CHNA) every three years, followed by implementing a strategy to deal with issues confronting the community, such as preventing violence or lowering the rates of diabetes. (Connor, 1/8)

Modern Healthcare: Charity Care Spending Flat Among Top Hospitals
The yearslong decline in free or discounted care that hospitals provide to patients may have reached its floor. The 20 largest U.S. health systems dedicated 1.4% of their collective operating revenue in fiscal 2016 to charity care—about the same as the previous year, a Modern Healthcare analysis of financial data shows. That's noteworthy considering the significant declines in charity care spending that followed the 2014 implementation of the Affordable Care Act, a law credited with insuring nearly 24 million people through expanded Medicaid eligibility and subsidized commercial plans. Total uncompensated care fell to a 25-year low in 2015 and held steady in 2016, according to the American Hospital Association. (Bannow 1/6)