Here’s an idea that seems unfair:
Hospitals, long searching for ways to minimize their streams of uninsured patients (written off as “charity” or “uncompensated” care), signed on to the Affordable Care Act (“Obamacare”) through their trade associations.
They stood to solve one of their longstanding problems by cooperating with Congress and the Administration to help Americans.
Obamacare is in part financed by funds earmarked for hospitals providing a “Disproportionate Share” (i.e. “DSH“) of unfunded care.
Now hospitals in states that aren’t expanding Medicaid not only won’t get payments from newly enrolled Medicaid-eligibles, they’ll be losing their “DSH” payments.
Here’s the thing, though: Stubborn governors and legislators who will not accept the 100% federal financing of Medicaid expansion will feel the bite. Eventually.
Hospitals will close. Citizens will be angered. Employees will lose jobs.
Those last two in any order.