Moody's outlines hospital economic concerns in states not expanding Medicaid; Iowa Democrats offer compromise; Idaho lawmakers weigh options

State legislatures around the country consider the implications of Medicaid expansion proposals under the federal health overhaul.

Modern Healthcare: Hospitals Face Dual Threat If States Don't Expand Medicaid: Moody's
Hospitals located in states that elect not to expand their Medicaid programs could find their bottom lines squeezed in the coming years as they're hit with higher charity-care costs and fewer insured patients. A report from Moody's Investors Service estimated that the Patient Protection and Affordable Care Act is expected to eliminate more than $17 billion in annual aid by 2019 when the government reduces its disproportionate-share hospital payments, which compensate facilities that treat large numbers of low-income patients. Lisa Goldstein, associate managing director at Moody's, said in an interview that safety net hospitals are likely to face the biggest hit to their credit ratings as uncompensated care increases and DSH payments dry up (Kutscher, 3/14).

Health News Florida: Feds To FL: We're Flexible; Show Us Your Plan
Medicaid expansion for 1 million low-income adults in Florida may technically be dead, after committees in both the House and Senate voted to kill it. And yet, chances for an alternative plan that would accomplish the same goals are looking up (Gentry, 3/15).

St. Louis Beacon: Missouri Senate GOP Leaders Declare There's No Chance They'll Back Medicaid Expansion
Before leaving the state Capitol for a one-week recess, the state Senate's Republican leaders have issued a joint statement declaring, in effect, that there's no way they will support an expansion of Medicaid. Among other things, the leaders -- including Senate President Pro Tem Tom Dempsey, R-St. Charles -- say they don't trust the federal government to pay its share of the costs. Under the Affordable Care Act, the federal government is to pay all the costs of the Medicaid expansion for three years, and then at least 90 percent thereafter (Mannies, 3/14).

St. Louis Beacon: Business Groups Use Economic Arguments To Prod State Lawmakers To Expand Medicaid
Branson, Mo., gets plenty of good press for being a magnet for millions of visitors who love country music, specialty shops and other amenities in the southwest corner of the state. But the town drew a different sort of attention to itself last month when its Chamber of Commerce endorsed Gov. Jay Nixon's controversial push to expand Missouri's Medicaid program (Joiner, 3/15).

The Associated Press: Lawmakers Hold Hearing On Federal Health Care Law
Gov. Bobby Jindal may have decided Louisiana won't expand its Medicaid program, but state lawmakers don't appear so settled on the issue. Lawmakers got a crash course Wednesday on the details of the federal health care law for the first time since it was upheld by the Supreme Court, and the Senate and House Insurance committees asked for more analysis (Deslatte, 3/15).

Des Moines Register: Health Leaders Seek Medicaid Deal
Iowa hospital executives publicly prodded state leaders Thursday to resolve their dispute over whether to expand the Medicaid insurance program for the poor. "We would really like to see both (legislative) houses working on this together and the governor's office -- just lay down the political banners on this and work to do what's right for the patients of Iowa," Iowa Health System Vice President Sabra Rosener said in a forum at Des Moines' Central Library (Leys, 3/15).

The Associated Press: Iowa Democrats Continue Medicaid Expansion Push
Senate Democrats on Thursday proposed a Medicaid expansion that would let the state back out if federal funding fell short, but it wasn't clear whether the plan would overcome Republican Gov. Terry Branstad's opposition to growing the program in Iowa. The Democrats who control the Iowa Senate have been pushing to expand Medicaid, but the governor has expressed concern that the federal government doesn't have the money to fulfill its promises (Lucey, 3/14).

Des Moines Register: Senate Offers Medicaid Deal
Iowa Senate Democrats are offering what they describe as a compromise to provide Medicaid health insurance to thousands of additional low-income Iowans, but Gov. Terry Branstad says he'll proceed with an alternative plan in the Republican-led House. Democrats proposed Thursday to draft Medicaid legislation allowing the state to pull out of the expanded program if the federal government fails to fulfill a promise to fund 100 percent of the program with federal money for the first three years and up to 90 percent in later years (Petroski, 3/15).

The Associated Press: Idaho State House Committee Introduces Proposal To Expand Medicaid
In the wake of one bruising fight over a key provision of President Barack Obama's health care overhaul, Idaho's Legislature may embark on another: Whether to expand Medicaid for another 104,000 low-income people, to replace an existing program that pays the costs of the medically indigent. The House Health and Welfare Committee introduced the proposal Thursday in a package to eliminate Idaho's catastrophic health care program (3/14).