Southern Republicans opposed to Medicaid expansion look for other ways to help hospitals

The idea behind the Patient Protection and Affordable Care Act was that everyone would have health insurance, so the federal government wouldn't need to pay hospitals as much for treating the poor and uninsured. But the Supreme Court said states didn't have to expand the Medicaid program to cover people earning up to 138 percent of the federal poverty threshold, so 25 states have either refused to expand Medicaid or are still discussing it.

That has left many poor people in those states, unable to get health insurance or Medicaid. "Now Republican leaders in Georgia and Mississippi may be bailing out hospitals that will lose funding they would have gotten from Obama's health-care law," Ray Henry and Christina A. Cassidy write for The Associated Press.

Three rural Georgia hospitals have closed in recent months, and finances are becoming an issue for Atlanta's Grady Memorial Hospital because approximately 60 percent of the patients are uninsured or on Medicaid, and officials say the federal cuts might cost the hospital $141 million. "You're talking about a large number of uninsured; you're talking about a Trauma I center," said Chris Riley, chief of staff for Gov. Nathan Deal. "You're talking about a hospital that serves a very primary purpose, covers a lot of Georgia residents."

State Rep. Terry England says extra payments to hospitals would be cheaper than a Medicaid expansion, for which Georgia would have to start paying 3 percent in 2017, rising to the law's cap of 10 percent in 2020. Mississippi Gov. Phil Bryant argues that the federal government might not fund Medicaid as the law provides, saying told AP, "For us to enter into an expansion program would be a fool's errand." There is also debate about how much a Medicaid expansion would cost each state; generally, opponents point only to the cost, while advocates say expansion would create jobs in the health-care industry and provide tax revenue to offset or largely offset the cost. Kentucky Gov. Steve Beshear, the only Southern governor to embrace Obamacare, expanded Medicaid after studies predicted the cost would be recouped. (Read more)