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Opinion

Commentary: Missouri's working poor need better health care choices

The Kansas City Star

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March 30, 2009 01:13 PM

This editorial appeared in The Kansas City Star.

Uninsured patients and hospitals in Missouri got a double dose of bad news last week.

The House rejected a creative proposal to expand health coverage to 35,000 people. And a new report showed hospitals and communities are straining to care for uninsured patients.

The state's severe cuts in Medicaid eligibility in 2005 coincided with noticeable increases in patients who showed up at hospitals with no way of paying, according to a report commissioned by the Missouri Foundation for Health in St. Louis.

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Using data from 152 of the state's hospitals, researchers showed that uncollectible bills – known as bad debt – increased from less than $700 million in 2005 to nearly $1 billion in 2007.

Hospitals coped with the debt in various ways. They wrote off expenses as charity care, increased rates for insured patients, pleaded for help from communities and searched for federal reimbursement.

"While the overall changes … may have saved the state monies, those savings have either been passed on to the commercial market in increased charges or have been absorbed by (hospitals) through increases in charity care and/or bad debts," the report states.

The report helps explain why hospitals in Missouri have offered to pay the state an extra $52.5 million a year to expand Medicaid coverage. With that money, Missouri would qualify for an additional $93 million in federal funds for health care.

To read the complete editorial, visit The Kansas City Star.

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