Problems Joe Biden is not going to fix

Pull Up the Roots

Pull Up the Roots

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Kansas governor opposing the medicaid expansion seems to be a root cause (of the debt) and that's a holdover from Brownback. There have been a few studies showing that states that accepted the expansion helped cut medical debt (I agree this is something that shouldn't even exist in the first place) and save rural hospitals. It's even mentioned in the story. The judge situation is all kinds of fukked up, but that is something the state itself has to tackle.


Medicaid Expansion Could Be Key to Saving Rural Hospitals

The ACA affects all of us, not just individuals who aren't covered by insurance obtained through their job, spouse or parents. Medicaid expansion, one of the more controversial parts of the law, has been a life-or-death issue for many rural hospitals. I practice at a rural, nonprofit hospital in Alabama, and we have felt the effects of Medicaid not being expanded in our state. This past summer, our hospital drastically reduced staff and implemented several other cost-cutting measures to address financial shortfalls brought on by a large uninsured patient population and uncompensated care. This would undoubtedly have been prevented had Alabama expanded Medicaid. Many of the hospitals in our state and our state hospital association are actively supporting Medicaid expansion by lobbying the state legislature to address this critical issue.

Thirty-seven states have adopted Medicaid expansion programs(www.kff.org) since the ACA's implementation. Rural areas tend to have larger proportions of low-income populations that benefit from Medicaid expansion, so for those 37 states, it has meant that their more vulnerable citizens have had better coverage, more access to care, better affordability of care and better financial security among the low-income population. In fact, some rural areas in states that have expanded Medicaid have seen more than 20 percent reductions in uninsured populations.

Since 2010, 94 rural hospitals have closed(www.shepscenter.unc.edu) in the United States, and the vast majority of those have been in states that did not expand Medicaid through either the ACA or an alternative plan. Texas alone has seen 17 hospitals shuttered in the past nine years.

Conversely, Medicaid expansion has bolstered rural hospitals(ccf.georgetown.edu) in the states that have expanded coverage. This is important to remember when we consider that there are nearly 700 health care facilities that are vulnerable to closure.(www.ruralhealthweb.org)
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1 in 4 rural hospitals is vulnerable to closure, a new report finds

According to Chartis, being in a Medicaid expansion state decreases by 62 percent the likelihood of a rural hospital closing. Conversely, being in a non-expansion state makes it more likely a rural hospital will close.

The states that have experienced the most rural hospital closures over the last 10 years (Texas, Tennessee, Oklahoma, Georgia, Alabama, and Missouri) have all refused to expand Medicaid through the 2010 health care law. It seems their rural hospitals are paying the price. Of the 216 hospitals that Chartis says are most vulnerable to closure, 75 percent are in non-expansion states. Those 216 hospitals have an operating margin of negative 8.6 percent.

Research has consistently shown Medicaid expansion improves hospitals’ financial performance by reducing the amount of uncompensated care. The only question is by how much, as Medicaid payments can sometimes not be enough to match the cost of providing care to Medicaid patients, which can partially offset the savings in uncompensated care.

Nevertheless, here is how the Kaiser Family Foundation summarized the available research:

Studies demonstrate that Medicaid expansion has significantly improved hospital operating margins and financial performance. A study published in January 2018 found that Medicaid expansion was associated with improved hospital financial performance and significant reductions in the probability of hospital closure, especially in rural areas and areas with higher pre-ACA uninsured rates. Another analysis found that expansion’s effects on margins were strongest for small hospitals, for-profit and non-federal-government-operated hospitals, and hospitals located in non-metropolitan areas. A third study found larger expansion-related improvements in operating margins for public (compared to nonprofit or for-profit) hospitals and rural (compared to nonrural) hospitals.

As you can see, the consistent conclusion is that Medicaid expansion is particularly helpful for rural hospitals. And yet a state like Texas, where more than half of its rural hospitals are vulnerable to closure, still refuses to accept the generous federal funding that covers 90 percent of the costs for Medicaid expansion.
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Kansas:

Medicaid expansion passed in the Kansas legislature in 2017, but was vetoed by Republican Sam Brownback, the Governor at the time. In 2018, Democratic Governor Laura Kelly ran for office on the issue of expansion, but Republican leaders in the 2019 session blocked her expansion bill from a vote in the Senate despite its passage in the House on March 20, 2019. On October 23, 2019, Republican Senate Majority Leader Jim Denning proposed his own version of Medicaid expansion, which the Senate Select Committee on Healthcare Access recommended get further study in the 2020 legislative session. On January 9, 2020, Kelly and Denning announced a bipartisan Medicaid expansion bill that compromises between the 2017 bill vetoed by Brownback, the 2019 bill adopted by the House, and Denning’s October plan. The bill would expand Medicaid by January 1, 2021 and would fund the state’s share of the cost with a capped surcharge on hospitals. In addition to provisions such as premiums and a work referral program, the bill also directs the state to apply for waivers that would transition those between 100-138% of the FPL from Medicaid expansion coverage to Marketplace coverage, although the expansion is not contingent on approval of these waivers. The Senate bill is co-sponsored by 11 Republicans and 11 Democrats, and House members from both parties have expressed their support as well. Republican President Susan Wagle stalled the bill’s progress, however, by pledging not to allow a vote on expansion until an anti-abortion bill passed the House. The 2020 legislative session ended with no further progress on the bill after Democrats tried to force a vote on Medicaid expansion and failed on May 21, 2020.
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Mike809

Mike809

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ill_will82

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God Almighty said:
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I'm getting tired of this shyt with the attacks on Social Security. My thing is this if you have a severe illness or born with a disability that affects your ability to work then I don't understand why government is trying to make those ppl lives miserable. I'm was born with cerebral palsy and have scoliosis to add. People with actual issues that try to apply for Social Security always are the ones that get turned down for SS benefits appose to the folks that don't need the shyt. I been through the shyt.
 
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