Why Missouri hospitals cut 1,000 jobs in six months

Medicaid reform is imperative for the state, hospital argue

Missouri hospitals have eliminated 1,000 jobs, put a hiring freeze on more than 2,100 vacant positions, and canceled or delayed more than $100 million in capital improvements in the past six months, according to a survey from the Missouri Hospital Association (MHA).  

The state hospital group unveiled the survey findings this week as part of its campaign to push for Medicaid expansion in the state, the Associated Press reports.

Through the Affordable Care Act, the federal government will pay for states to expand their Medicaid programs for residents making up to 138% of the federal poverty limit (FPL).  The government will cover 100% of expansion costs until 2017 and at least 90% of the costs thereafter. However, state legislators have opted not to expand Missouri's Medicaid program.

Interactive map: Where the states stand on Medicaid expansion

MHA has joined the Missouri Chamber of Commerce and Industry in a campaign for expansion. Hospitals contend that the money is needed to support hospitals' finances that have been weakened by federal funding cuts, the high costs of treating the uninsured, and shifting hospital utilization patterns.

According MHA's survey, which included 84 of the state's 155 hospitals, the economic uncertainty has forced many members to make difficult financial tradeoffs. In the last six months:

  • 41 hospitals eliminated the equivalent of 998 full-time positions;
  • 49 hospitals implemented a hiring freeze on 2,145 vacant, full-time positions; and
  • 37 hospitals, including 26 from rural areas, were delaying or canceling capital investments totaling more than $100 million.

Chamber President and CEO Dan Mehan says the hospital job reductions, which account for approximately 2.5% of the roughly 126,000 full-time-equivalent hospital jobs in Missouri, are the start of "very real and dire trend." He says "quiet momentum" is building among lawmakers for a Medicaid expansion alternative that would create a program more similar to private-sector insurance.

How many jobs do your state's hospitals provide?

However, several Republicans remain opposed to Medicaid expansion in Missouri, the Associated Press reports. State Senate Appropriations Committee Chair Kurt Schaefer argued on the Senate floor Wednesday that accepting federal funding would have a "heroin effect," making it too difficult to leave the program if costs climbed too high (AP/Modern Healthcare, 3/26 [subscription required]).

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