When researchers test a new medicine or even a new program design, they often devise a study comparing results between a treatment group and a control group. People in the control group receive no treatment, and forgo any benefits if it is proven to work and avoid any side effects if proven harmful.
A trial is going on regarding healthcare in this country, and right now Oklahoma has put itself in the control group. In this case, being in the control group may not be in our state’s best interest. However, it will provide useful comparisons between our state and states that chose to expand Medicaid.
In 2012, in the same decision where the Supreme Court ruled the bulk of the Affordable Care Act (ACA) was constitutional, the court also ruled that the federal government could not force the states to accept the Medicaid expansion. The Medicaid expansion was intended to provide healthcare coverage for Americans whose income fell below 133% of the poverty level.
While the court ruled the federal government could not force states to expand Medicaid eligibility, it did keep the option alive for states willing to accept federal money for the expansion. In essence, the final decision on expanding Medicaid fell to the individual states.
However, declining the expansion does not leave states in the same situation they were in before the ACA was passed. In 2014, all states will begin to see a decline in the Disproportionate Share Hospital (DSH) payments the federal government grants to states to fund care for indigent patients.
States used DSH payments to help hospitals deal with unpaid medical bills, and DSH payments are decreasing because Medicaid was supposed to fill the gap. So it is important to understand that declining additional Medicaid funds leaves many hospitals at a financial disadvantage. (more…)