Florida Hospital Profits Will Massively Increase If Medicaid Is Expanded

Under the Affordable Care Act (ACA), Hospital Organizations' both future Hospital Operating Income and Bottom Line Income will be bolstered very robustly due to many of the Uninsured getting insurance and also due to the many of the Underinsured getting much better insurance.

And for Hospital Organizations operating hospitals in States electing to Expand Medicaid, this future Profit growth will be exceptionally robust.

There are specifically two items which will drive higher Hospital Organization profits due to the ACA and also especially due to States electing the Expansion of Medicaid.

First, there is the Operating Statement Provision for Bad Debts' earnings charge which will be dramatically reduced due to the substantially better insurance situation of hospital patients.  This Provision for Bad Debts' earnings charge is usually a separate report line on a Hospital Organization's audited Operating Statement.

And second, there is the Operating Statement Uncompensated Charity Care Costs' earnings charge for the amounts hospitals spend on charity care which will also be dramatically reduced.  This Estimated Costs for Uncompensated Charity Care is disclosed in a Hospital Organization's footnotes which accompany its audited financial statements.

So what about the amounts of these two items?  Well, they are humongous, especially when compared to the related Hospital Operating Income.

From a review of the Electronic Municipal Market Access (EMMA) and the SEC filings, below here are the most recent audited year's Provision for Bad Debts and Uncompensated Charity Care Costs for the 18 Florida Hospital Organizations which had Net Assets above $400 mil currently.  I excluded the All Children's Hospital at St. Pete and the Miami Children's Hospital:

				One Year	One
			One Year	Estimated	Year	One
		Most	Provision	Cost of	Total	Year
		Recent	For	Uncompensated	Earnings	Hospital
		Annual	Bad	Charity	Charge	Operating
		FYE	Debts	Care	of Both	Income
			mils $s	mils $s	mils $s	mils $s
Florida Hospital Organizations
Health Management Associates		Dec 2012	874	497	1,371	301
Adventist Health System		Dec 2012	331	302	633	512
North Broward Hospital District		Jun 2012	396	72	468	(114)
South Broward Hosp District		Apr 2013	348	108	456	88
Baptist Health South Florida		Sep 2012	282	95	377	83
Lee Memorial Health System		Sep 2012	159	164	323	45
Lakeland Regional Medical Center		Sep 2012	135	133	268	41
BayCare Health System		Dec 2012	138	86	224	199
Orlando Health		Sep 2012	60	119	179	27
Baptist Health Jacksonville		Sep 2012	113	35	148	86
Shands Teaching Hospitals&Clinics		Jun 2013	88	60	148	118
Sarasota County Hosp District		Sep 2012	70	54	124	(2)
Halifax Hospital Medical Center		Sep 2012	98	-	98	(3)
FL Health Science (Tampa Hosp)		Sep 2012	49	38	87	11
NCH Healthcare System		Sep 2012	44	35	79	1
Health First		Sep 2012	26	37	63	24
H. Lee Moffitt Cancer Center		Jun 2013	14	37	51	8
Nemours Foundation		Dec 2012	24	13	37	33
Total all 18			3,249	1,885	5,134	1,458
Provision for Bad Debts						3,249
Uncompensated Charity Care Costs						1,885
Operating Income Excluding Bad Debts and Uncompensated Charity Care Costs						6,592

So, these 18 Florida Hospital Organizations had Audited Total Hospital Operating Income of $1.458 bil in the most recent fiscal year audited.  Driving down this $1.458 bil Total Hospital Operating Income were Total Provisions for Bad Debts of a massive $3.249 bil and Total Costs of Uncompensated Charity Care of another huge $1.885 bil.  Thus, exclusive of these two earnings charges, Total Hospital Operating Income would have been $6.592 bil, which is a monstrous $5.134 bil higher than the reported $1.458 bil.
 
Granted these two gigantic earnings charges will not be totally eliminated with the ACA and in combination with States electing to Expand Medicaid, but a substantial amount of these two earnings charges will be eliminated, and especially so if States elect to Expand Medicaid, which is the predominant driver of these two earnings charges being very substantially reduced.

And the above two huge earnings charges are just for one year.

I really don't understand how a financially savvy State Governor and financially savvy State Legislatures could possibly vote to not Expand Medicaid.  The US Government is 100% funding the first three years of Medicaid Expansion.

Further, if Medicaid is Expanded, the Hospital Organizations will be getting these just huge increases in their annual earnings in each future year, which will ultimately accrue to the benefit of State citizens when they are hospitalized and will be paying much lower hospital charges.  It will also cut the US Debt markedly since the US Government is paying for a good chunk of these hospitalization charges.

I really can't understand why some State Governors and State Legislators would want to financially hammer their State Hospital Organizations, their State citizens and the US Government Debt load like this.

Very financially astute Republican State Governors like Ohio's John Kasich and Florida's Rick Scott, who also has a keen insight on this issue since he was formerly a CEO of a large hospital organization, already have this all figured out.  And so has Arizona Republican Governor Jan Brewer.

And so has the perceptive US stock market which has moved up dramatically the market prices of the common stocks of the Publicly-Held Hospital Organizations.  For instance, Florida-HQed Health Management Associates had its stock price close today at $12.87, which was a 666% increase from the $1.68 it was trading at just before the Obama Administration took office.