However, hospitals in non-Medicaid expansion states fared worse. Hospital operating margins for facilities in non-expansion states actually fell by 0.6 percentage points in 2014 and only increased by 0.8 percentage points in 2015.
A study showed that the drop in uncompensated care costs after Medicaid expansion did not offset Medicaid reimbursement shortfalls at non-profit hospitals. Hospitals across Montana saw their uncompensated care costs drop by over 53 percent from 2015 and 2016 and patient bad debt also fell by almost 36 percent in the same period. However, the decrease in uncompensated care costs and patient bad debt was not enough to balance Medicaid reimbursement shortfalls, the study concluded.