Hospital uncompensated care costs were about 21 percent, or $7.4 billion, lower in 2014 due to gains in health insurance coverage under the Affordable Care Act, according to a report released Tuesday by the Department of Health and Human Services.
More than two-thirds of the estimated reduction, or $5 billion, was in states opting to expand Medicaid to uninsured low-income adults, according to the HHS.
If non-expansion states had similar increases in Medicaid coverage as did expansion states, their uncompensated care costs would have declined by an additional $1.4 billion, the agency estimated in a release.
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As of March 6, 29 states and the District of Columbia had adopted Medicaid expansion and another six have it under discussion, according to the Kaiser Family Foundation. States where expansion is under discussion are Alaska, Florida, Missouri, Montana, Tennessee, and Utah.
States not considering it at this time are Alabama, Georgia, Idaho, Kansas, Louisiana, Maine, Mississippi, Nebraska, North Carolina, Oklahoma, South Carolina, South Dakota, Texas, Virginia, Wisconsin and Wyoming.
States with expanded Medicare will see an estimated reduction in uncompensated care costs of $5 billion, or 26 percent; a reduction in bad debt of $1.1 billion; and a $3.9 billion reduction in charity care, according to the HHS report.
States without expanded Medicaid will see an estimated reduction in uncompensated care of $2.4 billion, or 16 percent; an $800,000 million reduction in bad debt; and a $1.6 billion reduction in charity care, it stated.
A second HHS report looks at the economic impact of Medicaid expansion, including jobs and federal funding. For example, Kentucky, which was the first state to release a post-expansion study, estimates the economic contribution of expanded Medicaid to be $30 billion between 2014 and 2021, according to the report.