Without Medicaid Expansion, Missouri Hospitals Could Lose $400 Million

State hospital officials across the country have been speaking out in favor of the Obamacare provision that expands Medicaid coverage to an estimated 17 million low-income people across the country, urging their legislators to opt into the health care exchanges set up under the law. Despite the significant financial benefits for states that accept the expansion, some Republican governors have already threatened to reject it. In Missouri, health officials articulate the stark reality — struggling hospitals without enough funds that would eventually be forced to close their doors — that would be in store for their state if Gov. Jay Nixon (D-MO) does not accept the expansion.

The St. Louis Post-Dispatch reports that, if Missouri chooses to forgo the health insurance exchange under Obamacare, hospitals in the state could lose hundreds of millions in funding:

The projected loss of up to nearly $400 million would come from cuts to federal Disproportionate Share Hospital (DSH) payments, and at least one doctor has speculated the cuts could force some rural hospitals to close.

The cuts were to be eased by a Medicaid expansion that would add more than 300,000 Missourians to that program, but leaders in the Missouri House and Senate say they are likely to block that move.

“If you don’t expand Medicaid and you eliminate the DSH funding, you have the ability to significantly impact hospitals’ financials,” Missouri Hospital Association spokesman Dave Dillon said. “It’s extremely problematic.”

A professor of pediatrics in the Division of Neonatal-Perinatal Medicine at St. Louis University estimates that as many as 40 to 50 percent of rural hospitals in the state could close, if the expansion is not enacted and the funds from it are not replaced. In addition to rural hospitals, larger medical centers in St. Louis and Kansas City could also be hit with cuts.

Members of Congress have urged governors to “refuse to play politics with people’s health and publicly support expanding health care access to the thousands of people in your state who need it today.” Nonetheless, Republican governors in states including Florida, Mississippi, Texas, Wisconsin, South Carolina, and Louisiana have pledged to refuse the Medicaid expansion. Missouri’s own governor has not publicly taken a position yet.