For rural hospitals the fear of not having Medicaid Expansion could leave an impact on the bottom line. Content Exchange

Medicaid expansion in Missouri is facing challenges in getting funding but it would add needed relief to rural hospitals, officials said.

Joseph Abrutz Jr., Cameron Regional Medical Center administrator, said there are financial hardships that hospitals face in regards to compensation for care.  

"If you could expand patients having a third party to help them pay hospital bills, to me that is a positive," Abrutz said. "Yes to Medicaid expansion to help pay their bills and yes to get people expanded for insurance to pay their bills."

Abrutz said his hospital receives 60 to 70 cents on the dollar from every bill sent out to insurance companies, 40 to 50 cents on every dollar for bills sent out on Medicare and 10 cents on the dollar for people on Medicaid. 

"We're fortunate if one out of 10 people can pay their bill in full on the self-pay. We are 40% to 50%, Medicare, 35% to 42% insurance, 10% to 12% Medicaid and the rest is self-pay," Abrutz said.

Traci Gleason, a spokeswoman for the Missouri Budget Project, an organization behind the funding of Medicaid expansion, said the proposal Missouri voters approved would provide opportunities for close to a quarter-million Missourians, and rural communities would see a great impact from it. 

"Medicaid expansion will make sure that people do have insurance and those hospitals will be paid and they won't end up in the emergency room to treat chronic conditions," Gleason said. "Right now if you don't have other preventive care or aren't able to regularly maintain your health, things worsen and worsen until you end up in the emergency room."

Gleason said that out of 21 counties that had a high rate for low-paid, uninsured workers, 20 were rural counties. 

State Sens. Dan Hegeman, R-Cosby, and Tony Luetkemeyer, R-Parkville, have both been against the funding of Medicaid expansion due to budgetary concerns and there not being a specific funding source in the voter-approved proposal. 

The expansion is supposed to come to fruition starting July 1. 

"We're confident that this is going to move forward one way or another," Gleason said. "The assertions about the cost of expansion have routinely been addressed."

Clayton Anderson can be reached at Follow him on twitter: @NPNowAnderson.

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