Splitting hairs while the patient dies


    In lowkell’s morning news round-up we find a link to this Richmond-Times Dispatch PolitiFacts article:


    Here’s the short version:

    — Richard Saslaw says, based on an article he read, 40% of rural hospitals in states that do not expand Medicare will close.

    — PolitiFact says, No, the article says that 40% of rural hospitals in states that don’t expand Medicaid  are in the red and the lack of expansion will “exacerbate” their problems.

    Memo to PolitiFacts:  BFD!!!!!!

    Here in Virginia, one major rural hospital already has closed — not operating in the red, not “exaceerbated,” but CLOSED.  Lee Regional Medical Center, Pennington Gap, Lee County, VA closed in October 2013.

    In Lancaster County, Rappahannock General Hospital should have closed two months ago but they are hanging on.  And many other rural hospitals in Virginia are in the same shape.

    Recent studies by the Colorado Hospital Association show that hospitals in states that accepted Medicaid expansion are seeing REDUCED costs to treat charity (uninsured) patients and INCREASED payments from patients who now have insurance (Medicaid).



    Dick Saslaw needs to start hammering away using these CHA studies and PolitiFact needs to stop splitting hairs.  Meanwhile, our rural hospitals are facing disaster thanks to VA GOP refusal to accept Medicaid expansion.

    Go below the fold for the critical point.

    The Affordable Care Act did several things but two of the provisions of the ACA are critical to this discussion.

    1.  The ACA reduced the amount of money health-care providers — mainly hospitals — are reimbursed for treating charity and uninsured cases.

    2.  AT THE SAME TIME, the ACA opened up Medicaid to people whose income is up to 138% of the federal poverty level.

    The impact of these two actions is that, while hospitals will be reimbursed less by Medicaid, MORE PEOPLE WILL HAVE MEDICAID INSURANCE, thereby more than offsetting the lost reimbursement from Medicaid for uninsured patients.

    However, the SCOTUS ruled that states did not have to accept Medicaid expansion without touching the Medicaid expansion provision.  Thus, in states that have not accepted Medicaid expansion, hospitals are losing Medicaid reimbursement for uninsured people but these losses are not being recouped by having more patients with insurance.  As a result, hospitals in states that don’t accept Medicaid expansion are in a death spiral.

    And the VA GOP doesn’t give a great goddam.


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