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The huge impact of expanding Medicaid, in one chart


Unpaid hospital bills have fallen by a third in states that expanded Medicaid, a new report from Health and Human Services estimates.

Because of those steep declines, the Obama administration now expects that the Affordable Care Act will reduce the amount of uncompensated care that hospitals deliver by $5.7 billion in 2014.

Unpaid bills fall fastest in Medicaid expansion states

Different private hospital chains and state hospital associations have been tracking data on how many patients they admit who never pay their bill. And, as this chart from the HHS report shows, most states expanding Medicaid have had their unpaid admissions drop by about 30 percent.

The small handful of non-expansion states tracking this data saw little change, with uninsured admissions either decreasing or increasing slightly.


The data suggests that these uninsured people are showing up at the hospital with Medicaid coverage; during a similar time period, the Medicaid visits increased faster in the states that expanded the program. HCA, a national hospital chain, estimates that visits from Medicaid patients grew by 32 percent from the second quarter of 2013 to the second quarter of 2014.

If trends continue, unpaid bills will fall by $5.7 billion

Hospitals estimate that, in 2012, they provided $45 billion in medical care that patients never paid for. That number typically grows 6 percent year over year. HHS estimates that, with millions in Medicaid, unpaid bills will fall by $5.7 billion.

This explains why hospitals tend to be some of the biggest advocates for Medicaid expansion. In states with Republican governors, they've typically been some of the most vocal advocates for accepting the federal dollars — largely because lots of those federal dollars will ultimately flow to them.