Obama's proposed delay in cuts could cool off MO medicaid expansion debate

Apr 12, 2013

Credit nomadsoul1 / dreamstime

In his proposed budget, President Barack Obama wants to delay cuts to federal payments to hospitals, keeping the payments intact for an extra year. That could affect the debate over expanding Medicaid in Missouri.

Through what’s called the disproportionate share hospital payments or DSH payments, the federal government gives money to hospitals that provide a lot of free care to patients who are uninsured and can’t afford services. The Affordable Care Act, though, includes significant cuts to DSH payments.

These cuts have been one of the major driving forces behind the argument to expand Medicaid coverage to more uninsured, low-income Missourians. They were scheduled to begin next year, but President Obama’s new proposed budget wants to delay the cuts until 2015.

Still, Missouri Hospital Association spokesperson Dave Dillon says that shouldn’t be an argument to not increase Medicaid eligibility in the state.

“This may be one of those additional things that allow people to say that we don’t need to do this, this year. We do. We will continue to need to do this because of the massive amounts of cuts that are coming,” Dillon said.

Those cuts include reductions in the amount the federal government pays hospitals for providing care to Medicare recipients. Both the Affordable Care Act, or the ACA, and the recent federal budget sequestration include Medicare cuts.

“The ACA literally makes billions of dollars of additional cuts in Medicare to hospitals,” Dillon said.

With about five weeks left in the legislative session, Missouri legislators are still debating whether to expand Medicaid. Gov. Jay Nixon and state Democrats want to expand the program to cover up to 300,000 Missourians by 2020, but GOP legislators worry about the cost.