Senate Health Care Plan: Likely To Add Billions Of Dollars In Uncovered Expenses For Hospitals

MIAMI, FL — So where are Americans likely to turn if they no longer have access to health care through Obamacare? Who foots their bills?

In many large metropolitan areas, there are hospitals that — as a matter of policy — do not turn people away based on their ability to pay. While all hospitals are required to provide emergency care to everybody regardless of their ability to pay, precious few hospitals provide ongoing care for conditions such as cancer.

In the Miami area, Jackson Health System is one such institution that provides whatever health care is deemed necessary without consideration of a patient’s ability to pay. The increases in costs it faces without Obamacare are likely consistent on a percentage basis for similar hospitals around the country.

See also: GOP Health Care Plan: Elderly Take Brutal Hit — And 40 Is Now Elderly

Analysis of Charitable Cases

At Patch’s request, Jackson performed an analysis on the amount it spends each year to cover people without health insurance. The analysis revealed that roughly half of all the patients who seek out free or reduced medical services fall in the forgotten class of Americans between the ages of 50 to 64.

The analysis covered the years immediately prior to Obamacare and the first two years after the program took effect. Hospital officials provided a summary of fiscal years 2012 to 2015 and also determined the percentage of uninsured patients each year who seek help in the 50-64 age group.

Overall, Jackson spent around $50 million more on patients without health care in the years prior to Obamacare as compared to the first two years of the program. In each year, about half of the patients who needed help fell between the ages of 50-64.

Here is what the analysis showed in the first two years of Obamacare:

• In 2015, Jackson spent $340.5 million on people without health insurance. Of that figure, 50.7 percent of patients were between 50-64.
• In 2014, Jackson spent $336.1 million on people without health insurance of which 52.9 percent were between 50-64.

Here is what the analysis showed in the two years prior to Obamacare:

• In 2013, Jackson spent $365.4 million on people without health insurance of which 53.1 percent went to patients between the ages of 50-64.
• In 2012, Jackson spent $392.5 million on people without health insurance of which 50.8 percent went to patients between the ages of 50-64.

In interpreting the statistics, Jackson cautions that “there are many factors that may impact the budget of a hospital system, especially of a size like ours, that is not always attributed to a health care law.”

Looking at the first two years after Obamacare took effect in 2014, the analysis reveals that Jackson spent less of its budget covering people without health insurance in that period.

With respect to the two years prior to Obamacare taking effect, Jackson spent more of its budge covering people without health insurance. In the case of 2014, it spent $56.4 million less than it spent in 2012 and $52 million less in 2015 than it did in 2012.

"The current proposal to replace or change the Affordable Care Act addresses some of the urgent needs from health systems like Jackson,” hospital officials told Patch. “Since Florida never expanded Medicaid under ACA, the impact would probably be most pronounced among people who use ACA subsidies to buy insurance on the exchange.

“But without knowing how the subsidies or qualifications would change, we can’t really project how funding to care for uninsured and underinsured patients will be impacted long-term,” officials added. “Jackson does not do detailed revenue/volume estimates beyond the upcoming fiscal year so changes to ACA are not likely to have major impacts until after that time.”

Nevertheless, the analysis would appear to suggest that Jackson is likely to pay more to help people who fall off Obamacare under the planned replacement program.

The question is how much more of the health care burden will shift to organizations such as Jackson and whether they be able to keep up with the needs of the community or if they will have be forced to cut back their charitable services.

Jackson Memorial Hospital is part of the Jackson Health System. Photo by Paul Scicchitano.