Guest opinion: Small, rural health centers struggle to serve uninsured

2013-03-26T00:00:00Z Guest opinion: Small, rural health centers struggle to serve uninsuredBy STEVE MUTH The Billings Gazette
March 26, 2013 12:00 am  • 

This week our legislators will have an opportunity to vote on meaningful and positive changes in the health care delivery system in Montana. Our legislators will decide if they will expand Medicaid health insurance coverage to 70,000 low-income Montanans who now have no insurance. These Montanans now without coverage and who would receive coverage by the expansion of Medicaid include dishwashers, childcare workers, restaurant cooks, teacher assistants, retail salespeople, security guards, agricultural workers, and over 9,500 military veterans and their spouses.

The expansion of Medicaid coverage to these low-income Montanans should not be a politically partisan issue, and should not be decided by whether we support or oppose Obamacare. The proposed Medicaid expansion would initially be 100 percent funded by the federal government until 2021, and after that the federal government will pay 90 percent of the cost. The bills now before the Montana Legislature contain sensible “circuit breaker” provisions, meaning that new coverages would be terminated if the federal government did not live up to its promise to pay.

The expanded coverage would bring tremendous benefit to all Montanans, not just those who would be newly eligible for coverage. The expanded coverage would add an average of $700 million annually to Montana’s GDP. This infusion of funds, according to a study by the Montana Hospital Association, would help create 12,000 additional well-paying jobs in Montana, and bring with them increases in tax revenues.

26% uninsured

In Carbon County, 26 percent of the adult population less than 65 years of age lives without health insurance. At Beartooth Billings Clinic, bad debt and charity care (free or discounted health services we provide) increased 33 percent in 2012, translating to over $1 million of uncompensated care.

The proposed expansion of health coverage will save health care dollars in the state and improve the overall health of Montanans. Caregivers now absorb the loss when someone without insurance obtains medical care, whether by visiting the emergency room or a doctor’s office. When there is no insurance and the bill for services cannot be paid, the hospitals incur bad debt, and must cover their losses to stay in business.

These losses present great and potentially damaging problems for a great many of our Montana hospitals, and especially those in our many rural communities. And the increase in insurance premiums is a hardship for most everyone.

States rethink Medicaid

People with health insurance are healthier people, more often seeing a physician before medical problems become critical, cost less to treat and they are not the prime contributor for the increases in medical costs we struggle to deal with in this country.

Many states that at first vehemently opposed any expansion of Medicaid coverage have now reversed their positions, wisely realizing that this expansion of coverage is the best thing to do for everyone in their states. Whether or not Montana agrees to expand Medicaid coverage will not make a difference to the existence of Obamacare.

Refusing to expand this coverage will simply mean that money Montanans pay in taxes will be sent to the states who have made the decision to expand this coverage.

Steve Muth of Red Lodge is president of the board of directors for Beartooth Billings Clinic.

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