Even though the federal government will fund most of the Medicaid expansion under healthcare reform in states through 2016, at least 15 governors have expressed opposition to doing so, according to Healthwatch, the healthcare blog of The Hill online political magazine.
The reasons for opposition vary, including political positions that disagree with the passage of the Patient Protection and Affordable Care Act. States that have said “No” or are leaning toward not expanding include:
- Alabama
- Florida
- Georgia
- Indiana
- Iowa
- Kansas
- Louisiana
- Mississippi
- Missouri
- Nebraska
- Nevada
- South Carolina
- Texas
- Virginia
- Wisconsin
Here’s the full list of where states appear to stand and their reasons as of July 2012.
What does it mean if you lead a hospital in one of these states? HealthLeaders profiled Rick Perry’s position and its impact on Texas hospitals, which operate in a state that faces a $6 billion shortfall in its Medicaid program:
About 20% of the state’s [Texas’] adults live in poverty; 17% of children and 33% of adults are uninsured. The uninsured turn to the hospital emergency department for their healthcare needs. Their expenses are shouldered by others in the form of higher insurance premiums and higher taxes.
In a statement, Parkland Health & Hospital System in Dallas noted that in 2011 it provided $605 million in uncompensated care. “Those patients will still need healthcare and they will still come to safety net hospitals like Parkland for treatment. If our state is going to turn away hundreds of millions in federal funds, we are eager to see what our leaders will propose to replace them.”
Regardless of which state you operate in or your governor’s position, maintaining a consistent flow of revenue is critical now and will continue to be. For further reading, here are some previous posts to help you run a best practice revenue cycle:

