Charity care drops in states expanding Medicaid, study finds

States that participated in the Medicaid expansion provision of the Affordable Care Act saw significant decreases in the number of uninsured patients seeking care and the amount of charity care given by hospitals in the first quarter of 2014, according to a new study by the Colorado Hospital Association.

The CHA analyzed data from more than two dozen states, including both those that did and did not opt to expand Medicaid, and found those that had expanded Medicaid saw a 30% drop in average charity care per hospital, from $2.8 million in the first quarter of 2013 to $1.9 million in the first quarter of 2014. In the states where Medicaid has not been expanded, by comparison saw relatively no change, with $3.8 million average charity care in the first quarter of 2013 and $4.2 million in the first quarter of 2014. 

Similarly, Medicaid charges went up 29% in states that expanded Medicaid, while they remained the same in non-expansion states. 

Those changes for charity care and other charges in Medicaid expansion states indicate most new Medicaid enrollees were uninsured prior to expansion, accomplishing one of the key goals of the Affordable Care Act. 

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According to the Kaiser Family Foundation, nearly 5 million Americans who live in states avoiding expansion could be eligible for care under the program if those states were to change course. In Virginia, Democratic Gov. Terry McAuliffe may be exploring the option of going around the state legislature and expanding the program by executive order to enroll another 400,000 low-income Virginians in Medicaid, according to the Washington Post. 

In Alabama, protesters took to the state capitol this weekend to present Republican Gov. Robert Bentley with more than 10,000 petitions they’d collected from Alabamans calling for him to expand Medicaid. Hospital officials in the state this week have complained two local hospitals in the Jacksonville area have already lost $1.2 million in revenue this year and will likely lose more next year because the state hasn’t expanded Medicaid.