Even a partial repeal of the Affordable Care Act will have a great impact on hospitals.
A new report by the Urban Institute finds that a partial repeal of the health reform law would increase the amount of uncompensated care that hospitals and healthcare systems provide to the uninsured at a free or reduced rate by $1.1 trillion over a 10-year period.
“Healthcare providers stand to lose considerable revenue if Congress moves forward with partial repeal of the ACA through the budget reconciliation process,” the study noted. “If the reconciliation bill is modeled on the one President Obama vetoed in January 2016, then we estimate that about 30 million more people could be uninsured by 2019. As a result, healthcare spending by insurers (public and private) and households would decrease by billions of dollars every year.”
The study, funded by the Robert Wood Johnson Foundation, used the 2016 budget reconciliation package repealing the ACA as the baseline for their analysis. Since that bill delayed its repeal of most budget-related components of the ACA for two years, researchers said they simulated the cost and coverage implications of a similar 2017 bill in 2019.
The report found that a repeal would cause healthcare spending by Medicaid, private insurance and households to drop by $145.8 billion in 2019, but an additional 30 million uninsured people would seek $88 billion in uncompensated care.
Federal funding for uncompensated care would increase by no more than $3.2 billion in 2019 unless lawmakers took legislative action. And the financial burdens on state and local governments, healthcare providers and the uninsured would likely rise dramatically.
“The partial repeal of the ACA through a reconciliation bill being considered by Congress would create more uninsured people than would have been the case had the ACA never been passed,” said Matthew Buettgens, senior research associate in the Urban Institute’s Health Policy Center, in an emailed statement. “The increase in uncompensated care sought by the newly uninsured would be more than state and local governments and healthcare providers could internalize, undoubtedly leading to substantially more unmet medical need.”
The report was released just as Congress begins its plans to repeal President Barack Obama’s signature legislation. Uncompensated care costs have dropped dramatically since implementation of the ACA, which included provisions for states to expand Medicaid eligibility. One study concluded that uncompensated care costs dropped by $7.4 billion in 2014.