Heath Care Providers React to Ruling | Video

Michelle San Miguel | 6/28/2012

One thing both Bismarck hospital CEOs are happy about is that because the law was upheld, it means the Frontier Amendment still stands. The amendment provides St. Alexius and Medcenter One with millions of dollars in Medicare reimbursement every year to make up for the fact that North Dakota has, for a long time, received lower Medicare payments than other states.

Hospitals in Bismarck are busy enough with a growing population and now more patients will have insurance by 2014.

"If the wages continue, the wage demand continues to go up and there aren`t people to hire, that`s a predicament that does cause me some anxiety," said Medcenter One CEO and President Dr. Craig Lambrecht.

"We`ve been full in a number of areas. We try to hold patients in the ER or opening up in-patient beds, acute beds. We`re gonna have to seriously look at additional in-patient bed capability," said St. Alexius CEO and President Gary Miller.

Under the new law, more people will be eligible for Medicaid if their household income is below 133 percent of the federal poverty level, or about $31,000 for a family of four.

"Currently in the state of North Dakota for every Medicaid patient we treat, we spent a dollar, we get about 85 cents back in funding," Miller said.

The federal government will fully pay for those newly insured Medicaid patients until 2016. Then the state will slowly begin to take on some of those costs.

The new law includes a tax on health insurance. For those covered by Blue Cross Blue Shield of North Dakota, that means individual plans will increase by $65 a year and those with a family plan will see their annual costs go up by $200.

"Employers will find that they have employees whose wages are low enough that they might qualify for subsidies on the exchange and they do qualify for subsidies on the exchange it may makes sense in some cases for the employer to drop their group coverage and send their employees to the exchange. And in some cases the employee could be better off," said Paul von Ebers, President and CEO of Blue Cross Blue Shield of North Dakota.

Von Ebers says he plans to work with state leaders with the hopes of replacing it with another source of funding.

Perhaps the biggest uncertainty remains how state leaders will decide to expand Medicaid, which is jointly funded by the state and federal governments. The Supreme Court ruled today that whether states choose to expand the program is up to them.

Initially, the law said that states that chose not to expand Medicaid program would lose their federal Medicaid funding but that`s no longer the case.

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