Rural Missouri hospital one of many fearing hard times if states don't expand Medicaid

Medicaid has helped provide care to low-income families, especially children, the elderly and long-term care patients. States have the choice whether or not to expand Medicaid coverage under federal health reform, and while politicians argue about its merits, rural hospitals fear that without it they will suffer dramatically.

Jennifer Davidson of KSMU Radio in Springfield, Mo., offers an example of local reporting on the subject, describing how the loss of special Medicaid payments would affect rural Ozarks hospitals in Southern Missouri if the state does not expand the program. Ozarks Medical Center, left, in West Plains, near the Arkansas border, "serves over 150,000 people in one of the poorest congressional districts in the nation," she reports. One in five patients is covered by Medicaid. Missouri and Arkansas plan to expand Medicaid, but nearby Oklahoma does not and Kansas is undecided.

The Patient Protection and Affordable Care Act included a 75 percent reduction in Disproportionate Share Hospitals payments under Medicaid, which have been made to hospitals that are dependent on the program. The theory is that adding more people to the system will bring hospitals more revenue.

David Zechman, president and CEO of Ozarks Medical Center, told Davidson: "If you count the cut if the Medicaid expansion doesn’t happen, we’re going to see a 60 percent reduction in our bottom line. There aren’t very many businesses, or companies, that can survive in America with a 60 percent cut into their operating margin that keeps the current programs going, and allows you to recruit really good people to provide care, that allows you to pay people competitive salaries, that allows you to buy decent equipment and technology." (Read more)