Medicaid Expansion, Privitization Could Work Together

Apr 29, 2013


The state may need to accept the federal Medicaid Expansion to fund LSU hospitals under the new public/private partnerships.


That’s according to Steve Spires, with the Louisiana Budget Project, an advocacy group that focuses on the effects of policy changes to low- and middle-income households.

The money that’s been set aside for the partnerships has been budgeted in large part on the first three of eight partnerships.

There are two primary kinds of Medicaid dollars that currently fund charity hospitals. First is patient payments, gleaned by hospitals when Medicaid pays for care in full or in part for those that qualify.

“The second source of funding is the so-called ‘disproportionate share hospital’ dollars, or 'DSH' dollars,” Spires says. DSH funding is money the state gives hospitals to take care of the uninsured patients. It’s matched with federal funding.

Spires says the state needs to shift its reliance on DSH dollars to patient payments because, with the Affordable Care Act, Medicaid Expansion is expanding patient payments.

“When the law was written back in 2010, the balance that was struck was, they were going to dial down DSH funds, and replace it with Medicaid Expansion funds," Spires says. "The Medicaid Expansion money would more than offset the cuts to hospitals.” Whether or not a state accepts the expansion, DSH dollars will be decreased.

Lawmakers will consider the Expansion again on Wednesday.

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