Hospitals are big losers in states like Alabama that won’t expand Medicaid, 2 new reports state, September 3, 2014

Hospitals in Alabama will lose $7 billion in reimbursements from the federal government by electing not to expand Medicaid.

That's just one of the conclusions from a couple of recent reports evaluating the effects of states not choosing to adopt the Medicaid expansion aspect of the Affordable Care Act.

The $7 billion loss estimate in future funding from 2013 to 2022, comes from a report by the Urban Institute and the Robert Wood Johnson Foundation called "What Is the Result of States Not Expanding Medicaid?"

Another report, "The health system haves and have nots of ACA expansion," by the PwC Health Research Institute, says that in expansion states Medicaid admissions increased by a range of 10.4 percent to 32 percent across the country's three largest health systems since the beginning of the year.

"In states that have expanded Medicaid, an influx of newly insured patients has helped reverse long-running hospital trends such as declining admissions and a rise in uncompensated care," the HRI report concluded.

The Johnson-Urban study says that in the two dozen states that have not expanded Medicaid, 6.7 million people are projected to remain uninsured in 2016. Overall those hospitals are set to lose $167.8 billion in Medicaid funding , which was originally intended to offset big cuts in Medicare and Medicaid funds.

"Without a Medicaid expansion, hospitals are now faced with decreasing reimbursement and no increase in the number of insureds," Rosemary Blackmon, COO of the Alabama Hospital Association, said in a statement. "With hospital margins already razor thin, such cuts aren't sustainable without making tough decisions, such as cutting staff, eliminating services and in the worse cases, closing their door."

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