USA Today Projects That Medical Debt Will Persist Under Affordable Care Act

January 28th, 2014

Earlier this month USA Today conducted an analysis of how the amount of bad debt for hospitals will be affected by the Affordable Care Act.

Citing the same study from the Kaiser Family Foundation that was considered by TAG in our own projections about ACA earlier this month, USA Today found that the prominence of "bronze level" plans will play a significant role in the A/R for hospitals and medical centers.

Jayne O'Donnell and Paul Overberg wrote the report:

"Medical insurance deductibles for plans on the federal exchange covering 34 states average $3,000, and those for the least expensive, bronze-level plans average $5,082, according to the USA TODAY analysis of deductible data for HealthCare.gov. Those costs, according to a recent study, may still be more than many people can afford.


"The USA TODAY analysis also found the lowest out-of-pocket limits on HealthCare.gov plans were $4,350 for individuals on bronze plans and $8,700 for families, although these were not the norm and are likely paired with high premiums...The new health care law requires consumers' portions of health care expenses — known as cost sharing — to be capped at $6,350 for individuals and $12,700 for families...That makes it more likely consumers, especially those with chronic health conditions such as asthma or high blood pressure, will be hitting these out-of-pocket maximums, says Matt Eyles, executive vice president at consulting firm Avalere Health."

This is consistent with the opinion of many people that the Affordable Care Act will create problems for the A/R of hospitals. USA Today does not go so far as to say that bad debt will increase, though many others in the industry have wondered if that will be the case.

The report also quoted Joanne Peters, a spokesperson for the Department of Health and Human Services, who believes that despite these challenges, the implementation of ACA is still overwhelming positive. Said Peters:

""The new marketplace is night and day from what consumers faced in the individual market before the health care law, where they could see unlimited out-of-pocket expenses for plans with limited benefits and high deductibles, if they (could) even get coverage without being denied for a pre-existing condition."

The issue is complicated. Keeping the focus on 2014, the best thing hospitals can do is plan ahead and try to address the potential increases in bad debt that might be coming their way as the country navigates this new health law.

Link: USA Today - Medical debt will persist despite health law