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PRSRT STD ECRWSS U.S. POSTAGE PAID EDDM RETAIL Health High-tech health care news that keeps you in the loop. Missouri Lawmakers to Decide on Medicaid Expansion Missouri hospitals recently reported $1.1 billion of uncompensated care to patients in 2011. The Missouri Hospital Association says the figure includes $623 million in charity care provided at 129 hospitals—an increase of about 400 percent since 2004. When other unpaid bills were calculated, the total amount of uncompensated care escalated to $1.1 billion. These figures were released in tandem with a push for Missouri lawmakers to expand Medicaid eligibility to more adults—a move backed by Missouri Governor Jay Nixon. whether or not to expand Medicaid once again pits Democrats against Republicans or vice versa. Although Nixon and health care advocates contend that expanding Medicare is a nobrainer, Republican opponents have a far different view. "My first question to the governor is this: Where is the money to pay for this once the federal aid goes away," Republican House Speaker Tim Jones said. "The federal government is providing the funding now, but it is likely to disappear in just a few years as our nation comes to grips Under the Patient Protection & with our crippling national Affordable Care Act, more debt." commonly referred to as Affordable Care Act (ACA), According to the Kaiser Family Missouri hospitals could see Foundation, states that choose declines in reimbursement to opt in to the Medicaid dollars by $3.3 billion from expansion will receive 100 2013 to 2020. percent compensation from 2014 through 2016 for newly The Obama administration eligible enrollees' health care justifies these cuts as a result costs. of ACA: costs would be offset by increased reimbursement During this time, the states will from private insurance due to not have to use their budgets cover newly eligible the health care law mandate, to and/or increased funding enrollees. through Medicaid expansion. In Missouri, the debate over pay for 95 percent of the new enrollees' costs, with participating state governments having to cover the remaining 5 percent. The federal government will then gradually assume a smaller portion of the total costs each subsequent year, paying 94 percent in 2018, 93 percent in 2019 and 90 percent in 2020. For all subsequent years following 2020, the federal government will continue to pay 90 percent of new enrollees' costs. Missouri will have to foot the bill for the remaining 10 percent. Increases in Medicaid enrollment means the federal government would pay about $907 million in 2014, and by 2021 costs would rise to $2.3 billion. On the high end, Missouri's 10 percent share of $143 million would be paid from general revenues with an additional $116 million paid from other state sources such as hospital taxes and pharmacies. Expansion proponents say that Missouri's costs would be offset by decreased costs for mental health services, support provided to the disabled and Beginning in 2017, the federal pregnant women as higher government will continue to cont'd on page 2 Local Postal Customer Medicaid Expansion Expected to Stimulate Health Care Job Growth As Missouri legislators spar over whether or not to opt in to the expansion, there are approximately 15,945 uninsured people living in the 13 counties that make up West Central Missouri. And like all other workforce investment areas (WIAs) in the state, Medicaid expansion will reportedly have a significant impact on the area. According to the Missouri Foundation for Health's Economic Impacts of Medicaid Expansion report, here is how the economic landscape could be affected: Ÿ Total federal contribution to the expansion for West Central Missouri will be $538 million from 2014 through 2020 Ÿ Total state contribution to the expansion for West Central Missouri will be $22 million from 2014 through 2020 Ÿ If Missouri opts in to the expansion, an estimated 1,457 jobs will be created in the area in 2014—with the majority of these jobs in the health care sector Ÿ Total labor income from the expansion is estimated at $333 million from 2014 through 2020 Ÿ Total tax revenue generated by the expansion in West Central Missouri from 2014 through 2020 is estimated at $47,663,176 on the state/local level and $68,674,700 in federal tax dollars

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