Despite ACA, medical debt remains a big problem

The Affordable Care Act, with its individual mandate and subsidized health insurance policies, was intended to address the ongoing issue of medical debt. But it has barely made a dent in the phenomenon.

Millions of Americans continue to labor to pay off bills they had accumulated as the result of medical emergencies or ongoing healthcare issues. Kaiser Health News reported.

In fact, 64 million Americans had issues paying medical bills last year, according to a suvey from the Commonwealth Fund. That's down about 10 million compared to 2012, but a lot of industry observers believe the four and five-figure out-of-pocket costs newly insured patients have will likely exacerbate rather than alleviate the trend. Of those cited in the Commonwealth Fund study, 38 million--59 percent--had insurance for all of calendar 2012.

"There's wide acknowledgement in the healthcare community that high-deductible health plans in general are part of the problem," Jessica Curtis, director of the hospital accountability project at the non-profit group Community Catalyst told Kaiser Health News

Medical debt is considered the leading cause of bankruptcy. It can also still impact a person's ability to get a job or buy a house or car for years, according to Northeastern University Professor Daniel A. Austin.

Moreover, Curtis is also concerned that hospitals will continue to be aggressive in collecting debts from patients. Although the Treasury Department issued new guidelines that require hospitals to provide charity care to those patients who qualify, Curtis said the rules are "Swiss cheese" because there remains wide latitude in terms of how hospitals can interpret who qualifies for financial aid.

One provider in Missouri, Mosaic of Life Care, formed a for-profit subsidiary to sue patients and garnish their wages.

One couple profiled by Kaiser Health News, Britt and Elizabeth Harmon, racked up thousands of dollars of bills for treatment for their infant son's medical conditions. They've been working with a local charity to try and pay it off, but are still under considerable financial pressure.

"I've sold furniture out of my own house to try to pay off some of the bills," Elizabeth Harmon told Kaiser Health News. "There were so many bills, it was impossible to keep track of everything."

The federal Consumer Finance Protection Bureau said it was drafting regulations to address how providers collect medical debt, but their implementation is likely years away.

To learn more:
- read the Kaiser Health News article 
- read Daniel Austin's commentary