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The Affordable Care Act is already cutting health care costs, especially at hospitals that in the past provided charity care for uninsured, low-income patients. The reduction in charity care in states that have expanded their Medicaid programs with federal funds means the costs for this care are no longer being shifted to insured and self-paying patients, which makes health insurance more profitable for hospitals and insurers without increasing consumer costs. But this drop in costs is happening only in the states in about half of the nation that have expanded their Medicaid programs. The other states — mostly in the South and the Plains — have been involved in political struggles that have blocked expansion of health insurance for their poor residents. Expanding state-run Medicaid assistance programs has been called critical for the success of the new federal health care law.
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Bruce Hoffman P-8078 RAND is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. Papers are issued by RAND as a service to its professional staff. They are personal products of the authors rather than the results of sponsored RAND research. They have not been formally reviewed or edited. The views and conclusions expressed in Papers are those of the authors and are not necessarily shared by other members of the RAND staff or by its research sponsors. RAND® is a registered trademark. For more information or to order RAND documents, see RAND’s URL (http://www.rand.org) or contact Distribution Services, RAND, 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138, phone (310) 451-7002; Fax: (310) 4516915; Email: firstname.lastname@example.org Published 2003 by RAND 1700 Main Street, P.O. Box 2138, Santa Monica, CA 90407-2138 1200 South Hayes Street, Arlington, VA 22202-5050 201 North Craig Street, Suite 202, Pittsburgh, PA 15213-1516
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