Recently, a stakeholder group in Iowa put out a bold statement urging state legislators not to reject the Medicaid expansion: “Failure to seize this historic opportunity to significantly address the plight of uninsured Iowans has negative consequences for population health, Iowa’s health care infrastructure, and Iowa’s national competitiveness both economically and regarding overall quality of life.”

Sounds like it’s coming from consumer advocates, right?

Wrong. That’s the Iowa Hospital Association.

And Iowa’s not the only state where hospitals are showing up full-force in favor of expanding Medicaid. In Ohio, the hospital association put out a statement that they “strongly support the responsible implementation of Medicaid expansion.” In Texas, the senior vice president of the hospital association testified that if the state rejects the Medicaid expansion, they would in effect be enacting an additional $12 billion cut to hospitals.

This type of support for Medicaid from hospitals could be a game-changer in many states. As employers and important community institutions, hospitals have the trust of the public and clout with key decision-makers.

Our recent article (PDF) in Health Progress (the journal of the Catholic Health Association) highlights many ways individual hospitals – even in states where the hospital association as a whole is not taking a stance – can make the case for Medicaid.

  • Hospitals can help build the case—Local legislators may be unaware that rejecting the expansion would have negative financial consequences for the hospitals in their district. Hospitals can help inform them of the impacts on the hospital’s bottom line as well as the broader impacts on job creation and the private insurance market in the state.
  • Hospitals can engage policymakers—As large employers and prominent community institutions, hospitals can use this leverage to gain meetings with state lawmakers. Moreover, by partnering with other stakeholders—such as consumer groups—and engaging employees and board members as spokespeople, hospitals can publicize this issue in the media and in the community.
  • Hospitals can help build the bench—By engaging other hospitals in the area – both one-on-one and through organizations such as the state hospital association – hospitals can amplify the power of their message.
In all of these strategies, partnerships between consumer groups and hospitals can strengthen the voice of both constituencies. By pooling resources such as story banks or coalitions’ relationships with policymakers, providers and advocates can create effective strategies for a variety of audiences.

— Katherine Howitt and Kate Lewandoski, Senior Policy Analysts