How State Legislatures Are Reducing Hospital Funding

One of the ideas of Obamacare was to replace the Medicaid system, the method states use to provide medical services to the poor, with regular insurance coverage. Instead of a cumbersome separate system with its own rules and regulations that differ in every state, the poor would become eligible for the same kinds of health insurance as wealthier people, with part or all of their health insurance premiums covered by a federal grant to their states. The poor would not be absolutely required to participate in the insurance program, but if they did, they could only receive medical care costing as much as their medical insurance premiums would have cost.

The problem with the program has turned out to be that not every person whose income falls below the poverty line is eligible for Medicaid now, and states are refusing to expand Medicaid coverage, so many of the working poor will be entirely left out of the new program.

For instance, the State of Kansas limits Medicaid coverage to persons who earn no more than 26% of the   poverty level. That means a family of three with income greater than $4,963 per year earns to much to receive Medicaid, or to enroll in Obamacare.

The State of Virginia is even less generous. In Virginia, two parents and a child who earn more than 23% of the federal poverty level, more than $4,703 per year, will get neither Medicaid nor Obamacare. In Florida, that figure is $3,818 per year. In West Virginia, it is $3,054. And in Texas, it is $2,290. A family that earns $200 a month earns too much to receive help with medical bills in economic powerhouse Texas, even though the State of Texas would receive federal funding of $100 billion, with future state obligations of just $7 billion, to expand the program to its poor.

This means that while disproportionate share payments are being cut back, in 22 states dominated by anti-Obama legislatures, health insurance eligibility is not expanding to make up the difference.

Hospitals, however, are still required by federal law to provide care to anyone who needs it, whether or not they are paid. Moreover, the new Obamacare programs do not provide any coverage for the nation's 11 million illegal immigrants, who account for up to 95% of hospital costs at some facilities in Texas, Arizona, and Washington State.

If you are one of millions of people who won't be eligible for either program, there are still some things you can do--and we'll be explaining exactly what you can do in future articles. If you don't believe this is sensible policy, however, let your representatives and your governor know you expect better.