5 worst states for local government hospital costs

The Census Bureau has released newly compiled government survey tables that drive home a key health policy point: Cities, counties and special districts help pay plenty for health care.

Policymakers usually talk about the health care spending coming out of the federal government, state governments, private insurers, employers and patients, but local governments are also playing a part. They spent $90 billion on hospitals alone in 2012, up from $41 billion in 2002.

The local governments’ big and growing health care costs may contribute to some of the tension in states that have resisted using Patient Protection and Affordable Care Act (PPACA) money to expand Medicaid, and to the tension in states in which decisions to expand Medicaid have been controversial. State officials have been in charge of deciding whether to take the Medicaid money, and, in some states, local governments may have different health care spending levels and revenue sources than in others.

Of course, some states have high local government hospital spending levels because they’re huge. In California, for example, local governments spent a total of $37 billion on hospitals in 2012, but only $381 per capita.

See also: Individual health gains as group health shrinks

The national average local government hospital spending level was $292 per person.

For a look at the 10 states with the highest local government hospital levels, and a 50-state local government hospital spending table, read on. 

1. Alabama: $662

The Yellowhammer State has 4.8 million residents and about $3.2 billion in local government hospital spending.

See also: The 10 fattest states in the nation

2. North Carolina: $672

The Tar Heel State has 9.5 million residents and $6.4 billion in local government hospital spending.