Just got off the phone with David Ramsey, CEO of Charleston Area Medical Center
"I think most of us in the industry, at least on the hospital side, were anxious to have clarification so we can move forward."
Ramsey said he's concerned that, in a few years when states will be required to contribute financially to the Medicaid expansion, hospitals could be hurt. He said if the state comes up short for Medicaid money it may reduce reimbursements to hospitals.
Otherwise, he said the Medicaid expansion is a two-edged sword. It would pay for patients currently receiving charity care. But if the number of Medicaid patients visiting the hospital greatly increases, it could hurt CAMC's bottom line since Medicaid pays below cost.
Just got off the phone with Fred Early, Highmark West Virginia Inc. president
He says the Supreme Court's ruling won't make much of a difference for his insurance company. They're already making steps to get ready for the 2014 roll-out of health insurance exchanges.
More about Medicaid expansion from dissenting opinion from Justices Scalia, Thomas, Kennedy and Alito: "the achievement of that goal [of universal coverage] obviously depends on participation by every single State. If any State--not to mention all of the 26 States that brought this suit-- chose to decline the federal offer, there would be a gaping hole in the ACA's coverage. It is true that some persons who are eligible for Medicaid coverage under the ACA may be able to secure private insurance, either through their employers or by obtaining subsidized insurance through an exchange... But the new federal subsidies are not available to those whose income is below the federal poverty level, and the ACA provides no means, other than Medicaid, for these individuals to obtain coverage and comply with the Mandate. The Government counters that these people will not have to pay the penalty... but that argument misses the point: Without Medicaid, these individuals will not have coverage and the ACA's goal of near-universal coverage will be severely frustrated."
jared.hunt