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Health Affairs Explores Financial and Political Aspects of Medicaid

With the 50th anniversary of Medicaid this month, Health Affairs explored the financial and political influences surrounding Medicaid, including the Affordable Care Act’s (ACA’s) Medicaid expansion, Medicaid shortfalls and community benefit funds, and the impact of recent Supreme Court decisions on Medicaid.

Medicaid’s Evolving Financial and Political Landscape

Early Medicaid Expansion In Connecticut Stemmed The Growth In Hospital Uncompensated Care
Health Affairs (subscription required)

To study the impact of Medicaid expansion on hospitals’ financial situation, researchers analyzed hospital data from Connecticut, an early adopter of limited Medicaid expansion. Findings revealed that despite growing trends of uncompensated care in comparison non-expansion states, uncompensated care in Connecticut remained steady. The study also explored the impact on Medicaid discharges and found that Medicaid’s share of discharges almost doubled in Connecticut while remaining unchanged in other comparison states.

The Value Of The Nonprofit Hospital Tax Exemption Was $24.6 Billion In 2011
Health Affairs (subscription required)

This study explores how nonprofit hospitals allocate the savings they receive from tax exemptions following ACA guidelines. Reports from the Internal Revenue Service show that nonprofit hospitals allocated more than half of their community benefit funds to compensate for losses due to Medicaid shortfalls and financial assistance for patients. Notably, less than 8 percent of community benefit spending and less than 1 percent of all hospital expenditures were allocated to community health improvement in 2011.  

The Supreme Court Ruling That Blocked Providers From Seeking Higher Medicaid Payments Also Undercut the Entire Program Health Affairs (subscription required)

This commentary explores potential unintended consequences of the Armstrong v. Exceptional Child Center, Inc. ruling by the Supreme Court in March. The court ruled 5-4 that Medicaid providers do not have a right to sue states over the adequacy of Medicaid reimbursement. Viewed as a victory for states and Medicaid programs, the author worries that lower Medicaid reimbursement (Medicaid rates average 66 percent of what Medicare pays, according to analysis by the Urban Institute) will be detrimental to beneficiaries’ access to primary care as participating providers might fall away.

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About the Author

Laycox is a former senior writer/editor for America's Essential Hospitals.

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