We write in response to the op-ed piece regarding Medicaid expansion that appeared in the Jan. 14 Independent Record.
The Montana Hospital Association and the Montana Medical Association represent hospitals, physicians, nursing homes, home health agencies and hospices. The MHA and MMA support expanding health insurance coverage to low-income Montanans.
The most important factor in our decision is that Montanans without health insurance are generally less healthy than those who have some kind of coverage. They are much less likely to have a source for primary care and more likely to use the emergency room to obtain their care. In addition they have higher levels of medical debt.
Health insurance coverage changes all this. Providing coverage will help ensure Montanans receive appropriate care in an appropriate setting; it will improve the health of this important segment of our population.
Experience in other states indicates that if we provide coverage to the 69,000 currently uninsured who would qualify for this expansion, at least 300 fewer Montanans would die each year. This, by itself, should be reason enough to move forward, but there are others.
A coverage expansion also presents an opportunity for Montanans to redesign how we deliver health care. A number of programs now funded by state tax dollars could be shifted to the new coverage program – saving millions of dollars a year in state spending. This money could be reserved to help offset the state’s share of the cost of the expansion after 2017.
In addition, meaningful cost containment measures could be enacted to significantly increase the value we get for the tax dollars we spend for Medicaid services. With more Montanans covered by insurance and innovative models of care that focus on wellness and prevention and appropriate utilization of health care services, we can bend the health care cost curve. We can do a better job of managing the care provided to covered individuals and reducing wasteful spending in the health care system.
These measures would mitigate the state’s future financial obligation, but, even so, if Montana finds expansion to be unaffordable, the state can opt out.
Expanding coverage will create an estimated 12,000 new, high-paying jobs around the state. Income paid to health care workers will ripple throughout the state and generate jobs on Main Streets all over Montana. This could be one of the best long-term investments we make in our state.
Uninsured, low-income Montanans still get sick and require medical treatment; unfortunately, they often cannot afford to pay for that care. Montana’s hospitals last year provided $350 million in care for which they were not paid. This doesn’t include the millions of dollars of uncompensated care provided by physicians and other providers. Much of this care was provided to low-income, uninsured patients.
Montana’s medical providers cannot absorb these unpaid costs. As a result, providers are forced to charge higher prices to privately-insured patients, which in turn, contributes to higher insurance premiums. This is essentially a tax on employers and employees; it is not good for business.
Increasing the number of Montanans with health insurance coverage should help stabilize insurance premiums by reducing the amount of uncompensated care provided to uninsured residents.
The writer leaves the impression that health care for Medicaid beneficiaries is substandard. Nothing could be farther from the truth. Patients receive the same quality of care, regardless of their insurance status. Unfortunately, all too often, uninsured patients decide to forgo provider-recommended medical care because they cannot afford it.
Coverage expansion is good for Montana’s health and for its economy. It would improve the health of a significant population of our fellow citizens, help stabilize insurance premiums and provide an opportunity to meaningfully reform the way we deliver care.