Posted: Mar 21, 2013 7:04 PM by Marnee Banks - MTN News
HELENA - There has been much discussion in the Montana Legislature about expanding Medicaid to cover 70,000 more low-income Montanans. Reporter Marnee Banks takes a look at how this could impact hospitals across the state.
Anyone who walks into an emergency room in Montana will be treated, regardless of their ability to pay for services; if the patient can't pay, the hospital absorbs that cost - it's called charity care, and last year Montana hospitals provided an estimated $125 million in charity care.
John Flink of the Montana Hospital Association said, "Hospitals can't absorb the kinds of unpaid costs that they incur, when they treat people who are uninsured."
So hospitals have to charge someone for that care, and most often it's people with private insurance.
MT State Representative Chuck Hunter (D-Helena) and the Montana Hospital Association both believe if the state expands Medicaid it could fix the problem.
Hunter said, "By providing coverage, providing the health insurance benefit to people who don't have it today, we can actually deal with that cost-shifting problem and our providers should end up in a better position than they are right now."
But not everyone is buying it, especially Republicans, who argue that hospitals are already losing money serving Medicaid patients.
Data shows that hospitals lose ten cents for every dollar of care they provide to a Medicaid patient.
MT State Representative Cary Smith (R-Billings) said, "It just doesn't seem like good business to me to try to add more people to a failing system, that the outcomes aren't as good as private insurance. So no, I can't see there would be any way that I would think we could do something that would get me to think Medicaid expansion is a good idea."
So Democrats are suggesting that the Legislature increase how much the state pays providers to serve Medicaid patients.
Flink says this will help address cost-shifting, but expanding Medicaid will have the bigger impact.
He says uninsured Montanans are costing them a lot more than the patients currently on Medicaid: "Our idea is that getting paid something is better than getting paid nothing."
But getting Republicans to sign on is going to be a tough sell.
The cost to expand Medicaid totals $25 million and it's money they say the state doesn't have.