Thursday, September 05, 2013

Not expanding Medicaid is a rural issue, rural health economist tells rural-health meeting

More than half of rural Americans who would be covered by expanded Medicaid live in states that opted not to participate in the expansion, M.L. Johnson reports for The Associated Press. Tim McBride, a health economist with the Rural Policy Research Institute, said during last week's National Rural Health Association convention in Milwaukee, “Not expanding Medicaid ... is a rural issue. I don’t see an upside to not expanding. The truth is, this will be really important money for rural hospitals, rural health providers, rural communities.”

McBride "warned those at the conference that their hospitals, as well as patients, are likely to be affected because the expansion is being paid for, in part, by cutting reimbursement rates," Johnson writes. "That means hospitals in states that have opted out won’t get any of the federal expansion money but will still see rate cuts."

He also said "the federal government has yet to grapple with increased spending on Medicaid, Medicare and Social Security," Johnson writes. "But the health-care overhaul should help rural residents overall, he said, because they are less likely to have employer-provided insurance and more likely to be uninsured or rely on government-funded insurance than those in cities." (Read more)

Twenty-one states say they will not participate in Medicaid expansion to people with incomes up to 138 percent of the federal poverty threshold. That includes Florida, where the Republican legislature rejected Republican Gov. Rick Scott's expansion move. The map by the Kaiser Family Foundation shows those states in orange. Dark blue states are participating, and light blue have yet to decide. Those with asterisks are exploring an approach that is likely to require federal approval, such as using Medicaid money to buy private insurance.

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