June 19, 2013

Hospitals: Maine Medicaid expansion would help

By insuring more people, the bill, still viable with an override of Gov. LePage's veto, could offset the escalating costs of free care, they say.

By JOE LAWLOR Staff Writer

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In this September 2012 file photo, interpreter George Bentley talks to Rina Yadira Galan with instructions and advice from Nurse Practioner Nicole Mizner, at left, before a young patient is discharged from Maine Medical Center in Portland. The cost of free care provided by Maine hospitals to uninsured patients has more than doubled since 2007, and those expenses will continue to grow unless Maine Medicaid expansion becomes law, hospital officials said.

Gregory Rec / Staff Photographer

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One more complicating factor is how many uninsured people sign up for coverage through new health care exchanges that are slated to begin in 2014.

The exchanges will make insurance available to the self-employed, other individuals and small businesses with fewer than 50 employees. But how many will take advantage of the exchanges -- and how that would affect the total number of uninsured -- is unknown.

If Medicaid expansion is approved and new health care exchanges for individuals to purchase health care work as planned, free care and "bad debt" expenses would decline significantly, perhaps as much as 70 percent, according to Al Swallow, vice president and chief financial officer of Maine Medical Center in Portland. "Bad debt" is when patients can't pay all or some of their bill, and Swallow said much of that debt, like free care, is also related to people being underinsured or uninsured.

Swallow cautioned that those savings are far from a sure thing, however. "I wouldn't guarantee (the savings), and I wouldn't budget for it," he said.

Swallow also said any savings would be somewhat offset by cuts to Medicare and Medicaid reimbursements.

Michael Hachey, chief financial officer for Mercy Hospital in Portland, said he sees the financial costs and benefits of the law as "a wash." But, he said, the hospital would prefer a Medicaid expansion rather than continuing to treat people who can't pay any of their bills.

"Most people want to pay their bills, but they just can't," Hachey said. "It would be better for the system if more people had access to health care."

Joe Lawlor can be contacted at 791-6376 or at:


Twitter: @joelawlorph 

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