The rise in out-of-pocket health costs worries hospital operators now forecasting a downturn in admissions if patients don’t get relief from high deductibles and co-payments via subsidies under the Affordable Care Act.
Already, hospitals are seeing soft admissions as employers and commercial carriers shift more out-of-pocket costs onto workers for their surgeries and related hospitalizations. It’s a trend hurting large hospital operators like Tenet Healthcare and HCA Holdings and is beginning to spread to nonprofit hospitals and health systems as well.
Ending one of the private insurance subsidies created by Obamacare to help more than 7 million people pay for their coverage would end up costing — not saving —the federal government money, according to an analysis from the nonpartisan Kaiser Family Foundation released Tuesday.
That’s because stopping subsidies for out-of-pocket costs like deductibles would indirectly increase the cost of a broader subsidy that helps reduce monthly premium costs.
The Trump administration is sending mixed messages on billions of dollars in federal payments that make deductibles affordable for millions of Americans and are a top priority for health insurers considering whether to sell Affordable Care Act health plans next year.
The administration said it will continue making the payments while a lawsuit that challenged whether they are legal is ongoing. But a spokeswoman stressed Tuesday that no final decisions have been made about the long-term future of the payments or the lawsuit.
“The administration is currently deciding its position on this matter,” Alleigh Marré, a spokeswoman for the Department of Health and Human Services said in an e-mail. “No decisions have been made about how the administration will proceed.”
The Congressional Budget Office, or CBO, has been making projections on the future of Obamacare, and healthcare in general, for years. Initially, the CBO had projected that up to 21 million people would sign up for private health insurance using Obamacare’s transparent marketplace exchanges by 2016. However, that estimate has been substantially reduced to just 12 million. According to the Department of Health and Human Services, Obamacare enrollment totaled “about 12.7 million” as of the end of third enrollment period (Jan. 31, 2016). Ultimately, the CBO foresees private health enrollment via Obamacare topping out at between 18 million and 19 million people between 2018 and 2026.