The effect of
uncompensated care on hospital quality operates through its impact on hospital finances.
Vanessa Santarelli, CEO of the Maine Primary Care Association, said the state's 20 community health centers have been hit through increased
uncompensated care costs as the LePage administration also tightened regular Medicaid eligibility requirements and had two rounds of cuts of 40,000 residents.
Noting that Medicaid has escaped the cutbacks experienced by other welfare programs, such as food stamps, they observe that "Given that hospitals are an important political force at all levels of government, the factors requiring hospitals to provide
uncompensated care may thus have unintentionally assured Medicaid's long-term political stability."
Put differently, if there was no Medicaid, this population would still receive some health care and would pay only a small share of its cost, likely due to the large amount of
uncompensated care provided by hospitals.
(1) A majority (ie, $5 billion) of this decrease in
uncompensated care was realized by hospitals in the 28 states and Washington, D.C., which expanded Medicaid under the Affordable Care Act (ACA).
It would only reimburse providers and hospitals for
uncompensated care rendered to patients who come to their emergency rooms.
In exchange for providing
uncompensated care to working poor, the destitute, the undocumented, and the homeless, safety net hospitals receive Disproportionate Share Hospital (DSH) payments from CMS, which amounts to billions of dollars over the next several years.
Expanded coverage reduces hospitals'
uncompensated care, lowers "cost shifting" to businesses that see higher health insurance premiums as some of the costs of caring for the uninsured are passed on to them and strengthens local economies, the report said.
"Also, while hospital spokesmen claim that they have to take everyone regardless of ability to pay, hospitals get paid even when they don't get paid through the
uncompensated care scam.