The uninsured rate and uncompensated care are expected to climb, impacting insurance rates for Americans and disproportional share hospitals (DSH). The Republican tax-reform bill clears penalties related to the individual and employer mandates. Senator Susan Collins (R-Maine) gets a promise from congressional leaders that bills funding cost sharing reductions (CSR’s) and establishing state-level risk pools or other reinsurance vehicles will be passed in 2018.
In 2015, about 6.7 million Americans paid $3B in tax penalties for failing to be insured. And while subsidies continue for those with incomes below 400 percent of federal poverty level, without the mandate, individuals and families will have a value decision to make. Are the subsidies enough to encourage coverage? Will only the sick take advantage of this assistance?
If Congressional Budget Office estimates are correct, about 4 million fewer Americans will be insured in 2019 and 13 million fewer in 2026. If only the sick stay in the ACA exchanges, rates will go up, forcing more Americans out of the individual market. Many will seek employment in groups. Some will be uninsured and rely on Medicaid and bad debt and bankruptcy. Or, will the proposed state-run risk pools manage the sick folks that have been priced out of the individual market?
Are Republican’s done dismantling the Affordable Care Act?
Sen. Lindsey O. Graham (R-S.C.) tweeted last week,
To those who believe — including Senate Republican leadership — that in 2018 there will not be another effort to repeal and replace Obamacare — well you are sadly mistaken.
Read more about the next steps in Washington from Washington Post
Read about the impact of uncompensated care on DSH Hospitals from HealthLeadersMedia