After Refusing to Take Part in the Medicaid Expansion, Texas Has Experienced 17 Hospital Closures

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Texas, which declined the Medicare Expansion mandated under the Affordable Care Act, has suffered 17 hospital closures since 2010. More than a third of the state's hospitals are also losing money.

Indeed, rural hospitals in Texas and the 16 other states that chose not to expand Medicaid are struggling at worse rates than those in other parts of the country, according to an investigation by Kansas' Pittsburg Morning Sun and GateHouse Media.



According to the paper's research, 72% of all rural hospital closures since 2010 then have happened in states that opted out of the expansion. In Kansas, for example, two of every three rural hospitals are losing money and five have since shut their doors.

Experts quoted in the piece point out that the expansion would have provided coverage for "hundreds of thousands of uninsured residents" and helped rural hospitals, which often struggle financially, to remain solvent.



“The irony to me is that we’re paying federal income taxes to expand coverage in other states," Texas Organization of Rural & Community Hospitals CEO John Henderson, a supporter of the expansion, told the Morning Sun. “We’re exporting our coverage and leaving billions of dollars on the table.”

Medicaid expansion makes a significant difference in rural areas where people are more likely to be uninsured and their care often goes uncompensated. Texas' exposure is particularly high since it has the nation's highest rate of uninsured residents.

Texas and other states went to court to avoid the Obama administration’s mandated Medicaid expansion, and in 2012 the Supreme Court ruled they were not required to comply. That left about 638,000 non-elderly Texans in the Medicaid gap as of 2016, according to Kaiser Family Foundation research.

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