Uncompensated care costs at Missouri hospitals increased 469% between 2004 and 2014, according to the Missouri Hospital Association’s annual Community Investment Report. In 2014, the state’s hospitals provided $1.3 billion in uncompensated care, including $723 million in charity care and $590 million in bad debt. Missouri has not extended Medicaid coverage to low-income adults under the Affordable Care Act. “Hospitals continue to bear the cost of Missouri’s high uninsured rate,” said MHA President and CEO Herb Kuhn. “Other states are experiencing reductions in uncompensated care costs linked to new coverage. However, with more than $1 billion in uncompensated care annually, Missouri remains headed in the opposite direction.” According to the report, Missouri hospitals contributed a total of $2.7 billion in community benefits and $11.2 billion to the economy in 2014.