As Gov. Sean Parnell weighs the decision whether to accept federal dollars for Medicaid expansion under the Affordable Care Act, a few Juneau health care providers have varied perspectives on what it might mean for their bottom lines.
A report on expanding Medicaid in Alaska is expected to be released next month when Parnell reveals his 2015 budget proposal. Until then, Juneau’s health care providers aren’t making any guesses.
Juneau’s city-operated Bartlett Regional Hospital wrote off $10.3 million in bad debt and charity care in fiscal year 2013. That write-off is out of about $128 million in total revenue.
The hospital’s spokesman, Jim Strader, said the amount Bartlett writes off isn’t solely attributable to patients without health insurance.
“It can be somebody who’s paid on a payment plan for many years and just stops paying,” Strader said. “It could be someone who has a deductible that they’re unable to meet or someone who has exceeded the limits of their plan.”
Strader said neither the hospital nor the city has studied what an expansion of Medicaid in Alaska would mean for the hospital.
“I think we’re operating under the same assumption that a lot of people in the country are, that if more people have insurance or have primary care physicians, then emergency room visits would tend to be lowered,” Strader said. He added, “Generally speaking, from the health care provider’s perspective, the more people that have good insurance, the better chance of us getting compensated. That’s always true, but as far as anything more definitive than that, no.”
About half of the patients at Juneau’s Planned Parenthood clinic don’t have insurance, according to Planned Parenthood of the Great Northwest spokeswoman Kirsten Glundberg. Of those uninsured patients, Glundberg said about half pay out of pocket and the other pay nothing at all. Planned Parenthood offers cervical cancer screenings, birth control and screenings for sexually transmitted diseases on a sliding scale that depends on the patient’s income and household size. Glundberg said the clinic is able to make up the difference between the cost of the services and what the patient pays through charitable funds, but that having more patients with access to private health insurance or Medicaid would be ideal.
“Expanding Medicaid in Alaska would, bottom line, allow us to provide more health care for more men and women who need it,” Glundberg said. “We think it would be a good thing and our clients would be healthier and our organization would be healthier.”
Glundberg said most patients at the Juneau clinic are female and between 20 and 30-years-old. A patient without insurance can pay, depending on income, up to $220 for a cervical cancer screening.
“We’re going to be here no matter what whether the governor expands Medicaid or doesn’t expand Medicaid,” Glundberg said. “We’re still going to be here and offer that care, but it would certainly be positive for the health of the community if that expansion actually happened.”