Hospital franchises, Medicaid expansion debated
Del.
But after a two-hour dive Tuesday into Medicaid expansion and its financial implications by the special study committee he chairs, the only thing Orrock knows for sure is the big question -- who's going to go where for what kind of care -- is still unanswered.
Still, he says there will be legislation next year to reform
The program is supposed to ensure that care is accessible and affordable, while Medicaid expansion is aimed at covering health-care bills for some 300,000 low-income Virginians who don't have insurance now.
Hospitals say they need COPN protection to keep competitors from wooing patients from money-making services, such as cardiology, which help cover the costs of such money-losers as psychiatric care or obstetrics. Critics said the program creates monopolies that force up the cost of health care.
Orrock wants to know how many of the 300,000 likely Medicaid expansion beneficiaries already get "charity care," for which hospitals charge no money.
As an EMT, he said he's driven people to ERs when, if they had coverage, they might have gone to a doctor earlier on before their illness or injury became too severe.
The expansion of Medicaid to cover all Virginians with incomes below 138 percent of the federal poverty line -- that's equal to
The new state budget also boosts the average reimbursement Medicaid pays from about 72 percent of the code of providing care to about 86 percent, said
Hospitals, except for the big public ones, such as the
The impact on hospitals gets complicated, Lessard said.
Two new taxes are at issue.
One is a tax of 0.5 percent of total patient revenue. It means hospitals will pay an amount equal to about half of what they collect from Medicaid to care for Medicaid expansion patients, Lessard said.
A second tax will amount to about
"So where they were getting zero (for charity care), they'll be getting about
It's a big deal for
Lessard said expansion should reduce the amount of charity care that hospitals have to cover, but that they will still do some.
Orrock was a bit skeptical. Medicaid already covers pregnant women with incomes up to 205 percent of the poverty level, he noted.
In recent years, many General Assembly Republicans have pushed to end the certificate of public need program. They argue that the program just creates monopolies that keep the cost of health care high. Hospitals have argued ending the program would leave them financially strapped, especially as
State Sen.
Not all
"I've been doing a lot of listening today," said Del.
Ress can be reached by telephone at 757-247-4535
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