A better reconstruction bill can offset the loss of the hospital’s Medicaid gap

States that have not expanded Medicaid under the Affordable Care Act may benefit from the proposed funding Bridging the coverage gapAccording to the researchers, although there are other plans to cut public insurance plans.

President Joe Biden’s current draft Rebuild better actions Including provisions to increase Medicaid and expand coverage, especially for the 12 states in the gap in Medicaid expansion and residents whose income is below the federal poverty line.

If the bill is passed, hospitals in these non-expansion states will receive more than $6.8 billion in new funding in 2022, which is 15 times the $444 million planned for the domestic policy bill. Reducing disproportionate hospital funding for Medicaid, according to An analysis By the Urban Research Institute.

“Hospitals can certainly survive the DSH cuts,” said John Holahan, a senior researcher at the Urban Research Institute. “Although they lost some DSH payments due to the benefits to the entire state economy and the state hospital system, it would be much better to pass this legislation.”

From 2022 to 2025, when the Build Better Act plans to grant subsidies and new market eligibility to people in the Medicaid gap, Holahan said that even if the disproportionate hospital funding is cut by 12.5%, states will still receive A lot of expenditure.

He said that due to population differences, net gains and losses vary from state to state.

In Florida, the hospital is expected to receive $1.7 billion in funding from the increased coverage and lose $33 million in funding, resulting in a net income of $1.6 billion in 2022. Texas hospitals may receive 1.6 billion U.S. dollars and lose 157 million U.S. dollars, for a total of nearly 1.5 billion U.S. dollars.

The substantial increase in expenditure will cause hospitals in Georgia and North Carolina to exceed the reduced Medicaid allocations of $750 million and nearly $900 million, respectively.

Since adults below the federal poverty line already receive Medicaid in Wisconsin, the state will receive less federal medical subsidies, resulting in a slight net loss in the cost of Medicaid disparities paid to hospitals, but overall it is a net benefit.

Although non-expanded states will benefit in general, Holahan said that with the proposed changes in the domestic policy bill, the situation in a small number of individual hospitals may get worse.

Specifically, hospitals that provide services for large numbers of undocumented personnel may face larger funding cuts, and federal subsidies may not necessarily flow to hospitals that receive disproportionate reductions in hospital funding.

Holahan said that the City Institute’s analysis did not take into account the bill’s proposal to partially abolish the ACA rule, which requires people to be eligible for market insurance without “affordable” insurance. The bill will also increase cost-sharing subsidies for the lowest-income market participants.

Both provisions will increase the number of people covered by the market plan, the total amount of subsidies paid, and the hospital expenditures of those in the Medicaid gap.

Unless extended, the Rebuild Better Act will only provide higher subsidies and eligibility for people in the Medicaid gap for a few years, but the funding cuts proposed under the Act—and the nationwide cuts that have been repeatedly postponed under the ACA -Will be permanent.

Nonetheless, Kathleen Hempstead, senior policy adviser at the Robert Wood Johnson Foundation, said that for at least a few years, the financial benefits most hospitals will receive by closing the coverage gap and reducing the cost of health care for families below the federal poverty line should be substantial. It is easy to offset any reduction. , Which funded the analysis of the Urban Research Institute.

“Traditionally, hospitals have been vigorously advocating for expanded coverage because it reduces unpaid care,” Hempstead said at a press conference.

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