Insurance News - Four Reasons To Accept Federally Paid Medicaid ...

By Wayne Greene, Tulsa World, Okla.

July 22-- Here are four key arguments for accepting a federally funded Medicaid expansion under the Affordable Care Act:

1. Medicaid expansion reduces the number of uninsured Oklahomans.

Oklahoma has 624,480 uninsured people, according to the Oklahoma Health Care Authority. By accepting the Medicaid money, the number of uninsured poor people could be cut by 53.1 percent, according to a 2010 report from the Kaiser Commission on Medicaid and the Uninsured.

Reducing the number of uninsured Oklahomans reduces costs for everyone and makes the health-care system work better, said Dr. Gerard Clancy, president of the University of Oklahoma-Tulsa and a physician.

Often the uninsured skip preventative and screening treatments, meaning preventable or treatable problems end up as acute ones in emergency rooms, Clancy said.

Instead of dealing with high blood pressure, an uninsured patient might end up seeing a doctor for the first time with a stroke or heart attack. The patient's health-care costs end up being much higher and are passed along to insured patients at the hospital.

Meanwhile, insured patients with actual emergencies end up with longer waits for treatment at hospital emergency rooms because it is the only access point for uninsured people, Clancy said.

"We see every day the results of individuals not receiving health care because they don't have insurance," he said.

2. Medicaid expansion protects Oklahoma hospitals.

Hospitals are going to end up treating Oklahoma's indigent population no matter what happens, said Oklahoma Hospital Association President Craig Jones.

The only question is whether those costs will be paid with federal money.

Budget savings built into the Affordable Care Act will cost U.S. hospitals some $153 billion over 10 years in cuts to Medicare programs and disproportionate share funding, which reimburses hospitals for unpaid indigent care.

If Oklahoma doesn't accept the Medicaid money, it will be subsidizing the costs of other states without receiving any of the benefits, Jones said.

For some hospitals -- especially small hospitals in high-poverty areas that were already financially stressed -- that loss would be troubling, he said.

Jake Henry Jr., president and CEO of Saint Francis Health System, said large, urban hospitals would also feel the pinch. The hospital would lose $14.8 million in payments if Oklahoma didn't accept the expansion, he estimated.

In the system's most recent fiscal year, Saint Francis cared for 36,355 Oklahomans who had no insurance.

"Ultimately, caring for all people underpins Saint Francis Health System's faith-based mission," Henry said. "In these troubled economic times, ignoring an opportunity to expand Medicaid coverage for our disadvantaged neighbors makes that task all the more difficult."

3. Medicaid expansion will spur the Oklahoma economy.

Accepting the Medicaid expansion would bring billions in federal funding to the state.

A recent Urban Institute study estimated federal Medicaid spending in the state would rise $5.771 billion from 2014-2019.

That money would drive more Oklahomans to seek medical services, resulting in an increase in demand for medical jobs.

Estimates prepared for the Oklahoma Health Care Authority predict the Medicaid expansion would result in more than 24,000 jobs being created in the state with average annual earnings of $574 million by 2020.

Those jobs -- many at the high end of wages -- would ripple throughout the economy, including state finance. The authority's estimate predicts the state would receive $82 million more in tax revenue from those jobs than the state would have to pay for its share of the Medicaid growth.

The Urban Institute study also argues that while states would have to spend some money on Medicaid, the result would be a substantial overall budget savings because a variety of other state expenses, including uncompensated care, would go down. The study estimates that Oklahoma could expand Medicaid and have a net budget savings of as much as $367 million from 2014-2019.

Another economic benefit is harder to estimate but should be familiar to Gov. Mary Fallin because it is part of her own stump speech.

The state's economic progress depends on having a healthy workforce. Raise the state's health level, and the state has more opportunities to thrive economically.

"Studies now rank Oklahoma 46th in the nation for the health of our citizens. That ranking is unacceptable and comes hand in hand with lost workforce productivity, hundreds of millions of dollars in medical bills and thousands of preventable deaths," Fallin said in her State of the State speech earlier this year. "For Oklahoma to move forward it must get healthier."

Fallin went on to say that the way to deal with the problem was through increased access to affordable health care through "free market initiatives," and by encouraging personal responsibility. The changes should come from the people of Oklahoma, not Washington, she said.

4. Medicaid expansion is philosophically the correct course.

Health care is a right not a privilege, said Rep. Jabar Shumate, D-Tulsa.

"If you're going to pursue your happiness, you need to be healthy," Shumate said.

The current health-care system assures that the wealthy get quality treatment and the poor can't afford to stay in the hospitals that they work to clean, he said.

That essentially works to make sure the poor never have a chance to escape their poverty, he said.

"We have a responsibility and people ought to expect to be able to get care," Shumate said.

It isn't unreasonable to expect people to contribute to the cost of their own health care to the degree that they can pay, but the Affordable Care Act seems designed to reach people at their own level, he said.

Wayne Greene 918-581-8308

wayne.greene@tulsaworld.com

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